Canadian Traumatologists and the Recognition of Occult Shock: Results of a National Survey
Bibliographic record
Abstract
ABSTRACT Introduction and objective Occult shock (OS) is important to recognize early in trauma patients, before perturbations in vital signs occur. Early trauma resuscitation is multidisciplinary in Canada. It is unclear how well Canadian traumatologists of all types recognize OS. Our objective was to explore the knowledge of OS in Canadian traumatologists. Materials and methods An on-line national survey was created for all multidisciplinary members of the Trauma Association of Canada (TAC). Survey questions explored the awareness, screening, prevalence, outcomes and treatment of occult and early shock. Results Response rate for TAC membership overall was 45%. Overall, 78% of respondents were aware of OS and 96% felt that trauma centers should be screening for this. Traumatologists were largely uncertain as to how many patients presented to their institutions in OS, or were screened for such an entity. One out of every five Canadian traumatologists did not know how to screen for OS with over half still relying on changes in vital signs for early detection. Fifty-eight percent of Canadian traumatologists only draw blood gases on patients that are already hemodynamically abnormal. The most effective way to reverse OS remained elusive. Conclusion Most Canadian traumatologists recognize OS as an important clinical entity with significant morbidity and mortality. Trauma patients, however, are largely being screened late, once vital signs have changed. This may have an impact on patient care across Canada. It is unclear if this practice pattern persists throughout the Americas with inherent ramifications in quality of care and patient safety. Clinical equipoise exists in the resuscitation of OS. How to cite this article Zakrison TL, Leung E, McCredie V, Nathens AB, Diez C, Rizoli S, Namias N. Canadian Traumatologists and the Recognition of Occult Shock: Results of a National Survey. Panam J Trauma Critical Care Emerg Surg 2013;2(1):33-36.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".