{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:43:07Z","timestamp":1780047787052,"version":"3.53.1"},"reference-count":14,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2022,3,15]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The trauma tertiary survey (TTS) is an essential part of the continued care for major trauma patients which is performed to ensure that all injuries have been identified and none have been overlooked during the patient\u2019s stay. Although the Advanced Trauma Life Support Course states a need for a tertiary survey, there is currently no standard for what this survey comprises.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using local consultant expert opinion and a literature search we identified a set of 32 TTS potential features that may be included within a TTS pro forma. Major trauma center (MTC) documents were requested from every MTC within the UK. 4 investigators sequentially interrogated each MTC TTS document looking for (1) presence of each feature and (2) how well the feature was represented on the document (0 to 4 Likert Scale). Any previously unidentified potential TTS features were noted and later reviewed for a second round of document analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 21 out of all 26 UK MTCs had a TTS pro forma document. A total of 68 possible features were identified. Respiratory and Abdominal assessment sections were the most frequently identified features (present in 90.4% of the TTS pro formas; n=19. Neck assessment and neurological assessment were included within 85.7% of the TTS pro formas (n=18). Further aspects identified for Round 2 analysis typically included features that were thought to be important but highly specific. For example, pregnancy test and DNACPR discussions were found in 1 MTC TTS each (4%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This article presents a review of the existing documents at 21 MTCs in the UK, identification of features used and proposes a gold standard TTS which can be used by any doctor to perform the tertiary survey and reduce the risk of missed injuries in trauma patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence<\/jats:title>\n                  <jats:p>3.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2022-000903","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T10:50:16Z","timestamp":1673002216000},"page":"e000903","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["UK-wide major trauma center tertiary trauma survey pro forma review and aggregation and consolidation into a redesigned document"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3653-5763","authenticated-orcid":false,"given":"Mark","family":"Parson","sequence":"first","affiliation":[{"name":"Anaesthetics, Royal Sussex County Hospital, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Pickard","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Royal Sussex County Hospital, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Simpson","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Royal Sussex County Hospital, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Treece","sequence":"additional","affiliation":[{"name":"Emergency Department, Medway Maritime Hospital, Gillingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-9217","authenticated-orcid":false,"given":"Lisa","family":"Rampersad","sequence":"additional","affiliation":[{"name":"Surgery, Royal Sussex County Hospital, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"2025082410351896000_8.1.e000903.1","unstructured":"Abuznadah W , Acker J , Agarwal S , Ali J , Allan H , Al Turki S , Asselstine M , Ayyaz M , Bagnall M , Baker A . American College of Surgeons.. ATLS advanced trauma life support student course manual. 10th ed.. Chicago: American College of Surgeons, 2018."},{"key":"2025082410351896000_8.1.e000903.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199006000-00002"},{"key":"2025082410351896000_8.1.e000903.3","unstructured":"Google LLC . Google Sheets online spreadsheet platform. 2021. https:\/\/www.google.co.uk\/sheets\/about\/ (6 Jul 2021)."},{"key":"2025082410351896000_8.1.e000903.4","unstructured":"Zoom Video Communications . Zoom Cloud Meetings video teleconferencing software. 2021. https:\/\/zoom.us\/ (6 Jul 2021)."},{"key":"2025082410351896000_8.1.e000903.5","unstructured":"Ogrinc G , Davies L , Goodman D , Batalden P , Davidoff F , Stevens D . Squire 2.0 (standards for quality improvement reporting excellence): revised publication guidelines from a detailed consensus process. -."},{"key":"2025082410351896000_8.1.e000903.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"2025082410351896000_8.1.e000903.7","doi-asserted-by":"crossref","first-page":"2474","DOI":"10.1016\/j.injury.2015.09.019","article-title":"Meta-Analysis of the effect of tertiary survey on missed injury rate in trauma patients","volume":"46","author":"Hajibandeh","year":"2015","journal-title":"Injury"},{"key":"2025082410351896000_8.1.e000903.8","doi-asserted-by":"publisher","DOI":"10.1177\/1457496915626837"},{"key":"2025082410351896000_8.1.e000903.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(03)00601-X"},{"key":"2025082410351896000_8.1.e000903.10","doi-asserted-by":"publisher","DOI":"10.1186\/1754-9493-2-20"},{"key":"2025082410351896000_8.1.e000903.11","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182028d71"},{"key":"2025082410351896000_8.1.e000903.12","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.injury.2015.11.040","article-title":"Tertiary survey in polytrauma patients should be an ongoing process","volume":"47","author":"Ferree","year":"2016","journal-title":"Injury"},{"key":"2025082410351896000_8.1.e000903.13","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s00068-019-01195-1","article-title":"High delayed and missed injury rate after inter-hospital transfer of severely injured trauma patients","volume":"46","author":"Hensgens","year":"2020","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025082410351896000_8.1.e000903.14","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1093\/ageing\/afx055.21","article-title":"21MAJOR TRAUMA IN THE OVER 65\u2019S: TOO LITTLE, TOO LATE","volume":"46","author":"Tompsett","year":"2017","journal-title":"Age Ageing"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2022-000903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:35:33Z","timestamp":1756056933000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2022-000903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,6]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/tsaco-2022-000903"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2022-000903","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}