Section: Application Domains

Management of severe trauma

(joint project with the Traumabase group, AP-HP)

Major trauma is defined as any injury that endangers the life or the functional integrity of a person. It has been shown that management of major trauma based on standardized and protocol based care improves prognosis of patients especially for the two main causes of death in major trauma i.e., hemorrhage and traumatic brain injury.

However, evidence shows that patient management even in mature trauma systems often exceeds acceptable time frames, and despite existing guidelines deviations from protocol-based care are often observed. These deviations lead to a high variability in care and are associated with bad outcome such as inadequate hemorrhage control or delayed transfusion. Two main factors explain these observations. First, decision-making in trauma care is particularly demanding, because it requires rapid and complex decisions under time pressure in a very dynamic and multi-player environment characterized by high levels of uncertainty and stress. Second, being a complex and multiplayer process, trauma care is affected by fragmentation. Fragmentation is often the result of loss or deformation of information.

This disruptive influence prevents providers to engage with each other and commit to the care process.In order to respond to this challenge, our program has set the ambitious goal to develop a trauma decision support tool, the TraumaMatrix. The program aims to provide an integrative decision support and information management solution to clinicians for the first 24 hours of major trauma management. This program is divided into three steps.

Based on a detailed and high quality trauma database, Step 1 consists in developing the mathematical tools and models to predict trauma specific outcomes and decisions. This step raises considerable scientific and methodological challenges.

Step 2 will use these methods to apply them to develop in close cooperation with trauma care experts the decision support tool and develop a user friendly and ergonomic interface to be used by clinicians.

Step 3 will further develop the tool and interface and test in real-time its impact on clinician decision making and patient outcome.