The association between seniority of Accident and Emergency doctor and outcome following trauma

The actual survival of patients treated following trauma in four Scottish T eaching hospitals during five years was compared with predicted survival ac cording to TRISS analysis, The data were analysed according to the seniorit y of the Accident and Emergency (A&E) doctor treating each patient. The gro up of patients treated by a consultant had a significantly better outcome ( p < 0.05) than the group of patients treated by junior doctors. Analysis of outcome according to the grade of junior A&E doctor suggested a step-wise improvement in outcome with seniority, thus supporting the concept that an; improved outcome; associated with experience and seniority. These results s upport calls for A&E consultants to be increasingly involved in the managem ent of patients with major trauma. Such increased involvement would require an increase in the number of A&E consultants. (C) 1999 Elsevier Science Lt d. All rights reserved.