Trauma names

[epsilonprodigy]

I am curious to know others' thoughts on our trauma naming system, where I went to school, we gave unidentified traumas random names- Trauma Zambia, Trauma Wizard, etc. this worked great and served as an extra reminder to get names changed over when possible.

At my program, they name them with numbers- Trauma 435, etc. I find this to be exceptionally dangerous. You then have a situation where Trauma 435 is in room 441, but trauma 441 is in room 468, and so on. It doesn't help that we have a confusing schematic of room numbering with some recurrent numbers, differentiated by letters. For example, there is a room B654 and a room C654.

I pointed this out to a nurse the other day when she kidded me about doing the "time out to end all time-outs" before a bedside procedure. She shrugged it off. It didn't used to bother me until I got far enough along to be doing procedures by myself, but now I think it's an accident waiting to happen.

Has trauma naming been studied? Who would I even start to talk to about this without coming off as totally obnoxious?


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[evilbooyaa]

My hospital for intern year did unidentified trauma names = Professional sports teams (NFL, MLB, NHL, maybe NBA). Eventually the name was found out and name was changed so things opened up, but that was the system. Not sure how they kept duplicates of names (rare but possible I'm sure) straight. I think it was like Bills, Buffalo 6 (if they were the 6th iteration of it), although it's not like you'd have to differentiate on the floor between Bills, Buffalo 4, 5, and 6.

I agree that unidentified people being numbers (especially while rooms are designated by numbers) is a terribad idea.

 

[Mad Jack]

I am curious to know others' thoughts on our trauma naming system, where I went to school, we gave unidentified traumas random names- Trauma Zambia, Trauma Wizard, etc. this worked great and served as an extra reminder to get names changed over when possible.

At my program, they name them with numbers- Trauma 435, etc. I find this to be exceptionally dangerous. You then have a situation where Trauma 435 is in room 441, but trauma 441 is in room 468, and so on. It doesn't help that we have a confusing schematic of room numbering with some recurrent numbers, differentiated by letters. For example, there is a room B654 and a room C654.

I pointed this out to a nurse the other day when she kidded me about doing the "time out to end all time-outs" before a bedside procedure. She shrugged it off. It didn't used to bother me until I got far enough along to be doing procedures by myself, but now I think it's an accident waiting to happen.

Has trauma naming been studied? Who would I even start to talk to about this without coming off as totally obnoxious?


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We gave everyone that was a John Doe an Irish name back at Big Medical Center. You'd be like, Billy O'Flannigan if you got stabbed. Was done to keep the gangbangers from figuring out who the patient was by sorting out that John Doe or Patient 441 was clearly their mark due to not having a real name (we had multiple instances of people trying to break into the hospital to finish what they started). I think your number system sucks, seems like a serious medical error waiting to happen.

 

[LucidSplash]

We used to do first name trauma,last name Greek letters with a random number (Episilon07, Trauma). For some reason that changed and now we do military letter words (Whiskey01, Trauma; Tango05, Trauma; Foxtrot08, Trauma). But the peds side didn't think that all those words were appropriate for kids (Whiskey) so they use some other system where we get peds traumas named stuff like Butterfly and Lego. No I am not joking.

 

[dpmd]

Agree the number alone is stupid dangerous. We did military alphabet plus a unique number (so it would be like whiskey, t35673 where the unique number proceeded in order so the next patient would be xray, t35674) that way they were forever findable in the system by that number even if they later got a name.

 

[AdmiralChz]

We do trauma plus an alphabetical list of things they have picked out, similar to other posters. They tend to recycle them after a year or two. Having a random number combination is just asking to have a medication administration error or worse, a procedure on a completely wrong patient. Doesn't pass the common sense test.

 

[epsilonprodigy]

Thanks to all! Wasn't sure if I was just being paranoid or fussy. I would love to see this change. It's especially tricky when we have multiple different EMRs within the hospital which don't "talk" to each other- when patients move from the trauma assessment area to the unit, everything has to be re-entered manually. That includes us residents getting the trauma number, MRN and account number and manually entering them onto a new note in the other (floor/ICU) EMR. It also means that you have to initially write 2 notes on every patient who comes through. It's a nightmare. It has made me hyper paranoid about double checking everything.


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[evilbooyaa]

Thanks to all! Wasn't sure if I was just being paranoid or fussy. I would love to see this change. It's especially tricky when we have multiple different EMRs within the hospital which don't "talk" to each other- when patients move from the trauma assessment area to the unit, everything has to be re-entered manually. That includes us residents getting the trauma number, MRN and account number and manually entering them onto a new note in the other (floor/ICU) EMR. It also means that you have to initially write 2 notes on every patient who comes through. It's a nightmare. It has made me hyper paranoid about double checking everything.


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It's one thing to have multiple EMRs across a hospital system (so a transfer from hospital to hospital is different EMRs), but to have two different EMRs in the SAME hospital (between ED and inpatient)? That sounds horrible. What about regular inpatient floors, is there a 3rd EMR for when the patient gets transferred out of the ICU to the floor?

 

[Mass Effect]

It's one thing to have multiple EMRs across a hospital system (so a transfer from hospital to hospital is different EMRs), but to have two different EMRs in the SAME hospital (between ED and inpatient)? That sounds horrible. What about regular inpatient floors, is there a 3rd EMR for when the patient gets transferred out of the ICU to the floor?

My hospital has multiple EMRs. ED has its own. Inpatient has its own. ICU has its own. Outpatient has its own. Residents have access to all, but they're different.

 

[dpmd]

The multiple EMR thing is even stupider than the number that looks like a room number thing.

 

[Mad Jack]

It's one thing to have multiple EMRs across a hospital system (so a transfer from hospital to hospital is different EMRs), but to have two different EMRs in the SAME hospital (between ED and inpatient)? That sounds horrible. What about regular inpatient floors, is there a 3rd EMR for when the patient gets transferred out of the ICU to the floor?

Every hospital I've ever worked at had a separate EMR for the ED and the rest of the hospital until recently. EPIC has unified things at most of the bigger hospitals, but many community hospitals are split between three systems- ED, outpatient, and inpatient.

 

[Raryn]

We had a system where they'd run through random words and initials.

So A Apple, B Dolphin, whatever.

 

[evilbooyaa]

My hospital has multiple EMRs. ED has its own. Inpatient has its own. ICU has its own. Outpatient has its own. Residents have access to all, but they're different.

Every hospital I've ever worked at had a separate EMR for the ED and the rest of the hospital until recently. EPIC has unified things at most of the bigger hospitals, but many community hospitals are split between three systems- ED, outpatient, and inpatient.

Wow. I just don't understand the logic of doing this. Or how C-Suite was able to get this (or why they would even push for this).

 

[LucidSplash]

Wow. I just don't understand the logic of doing this. Or how C-Suite was able to get this (or why they would even push for this).

We have separate systems for ED and hospital and then outpatients have their own too. But we're transitioning to Epic and it isn't cheap. The separate systems came into effect as something was selected for each setting at phases along the way. No one liked any one EMR enough to endorse or for the new setting so they chose something different and figured if it worked out well they'd integrate later on. But they all sucked. And as much as people hated the EMR, they didn't want to learn something new (e.g. White hairs). The switch to Epic has been painful and people still complain but at least it will be integrated. We only have it in the outpatient clinics at the moment but the inpatient go live is in the fall. I'll be gone by then so I won't have to hear that complaining.

 

[Chip N Sawbones]

My hospital kept changing the name category, which I guess is necessary when you handle 90% or so of the trauma in New Orleans. One week trauma names would be international cities, such as Trauma Edinburgh, Trauma Helsinki, and so on. The next week it would be movie characters. I really hope that trauma names sometimes get adopted by the patients as street names, and that one particular gangbanger who was brought in with multiple GSWs now goes by "Trauma Wookies" when he's hanging with his pals in the hood.

 

[gutonc]

The hospital where I was taken as a Level II trauma activation a year ago today uses a different car manufacturer every day and cycles through model names. They were doing Jeep the day I came in:

 

[evilbooyaa]

The hospital where I was taken as a Level II trauma activation a year ago today uses a different car manufacturer every day and cycles through model names. They were doing Jeep the day I came in:

All I hear in my head is Rage Against the Machine. You've officially got it stuck in there.