Evaluation of resuscitation with angiography, percutaneous techniques and operative repair (RAPTOR): hybrid suite introduction and initial use at a level I urban trauma centre.

Abstract

The aim of this study was to describe the utilization of the RAPTOR suite (hybrid theatre) for trauma patients. Ideally, this is used to achieve haemorrhage control in time-critical patients that may require damage control surgery (DCS) and/or interventional radiological (IR) procedures concurrently. A single-centre, retrospective study identifying all trauma patients that were treated at the level I trauma centre during 2011-2016 was performed. Patients that underwent treatment in the RAPTOR suite were described. Subgroup analyses were performed for trauma patients that underwent interventions within 60min and patients who underwent a combination of DCS + angioembolization in the RAPTOR suite or in other locations (OR, radiology). Since its introduction in 2011, 1% of all procedures performed in the RAPTOR suite were trauma related. From 2011 until 2016, 43 trauma patients underwent treatment in the RAPTOR suite. The majority of patients (81%) suffered blunt injury. Most patients were male (70%), with a mean age of 43years. The mean ISS was 38. In 56% (n = 24) the MTP was activated and in 40% (n = 17) a CT scan was performed prior to treatment. Damage control surgery alone, angioembolization alone and a combination of DCS and angioembolization were performed in 37% (n = 16), 23% (n = 10) and 40% (n = 17) of patients, respectively. Median time to the hybrid suite, procedure time and total time were 56min (15-704), 160min (42-404), and 251min (93-788), respectively. In the first 5years following introduction of a hybrid theatre in an urban level I trauma centre, only 1% of patients using the resource has injury-related pathology. Earlier identification of patients requiring this facility may improve timely access and management for this select group of patients needing urgent control of bleeding.