Population of interest

- Identify patients with IFI
- Patients with 3 or more risk factors for invasive fungal infection (dismounted blast, above knee amputation, perineal genitourinary or rectal injury, MT> 20 units RBC + WB within 24h of injury.)

Intent (Expected Outcomes)

- Patients with ≥3 IFI risk factors undergo surgical debridement undergo surgical debridement in the OR within 6-12 hours of arrival at Role 3 or 4 MTFs.

- Patients with ≥3 IFI risk factors and wounds concerning for IFI are:

taken to the OR at least every 24 hours

are started on IV or PO antifungals.

- An operative note for wound debridement includes the extent of necrosis quantified as a percentage of each wound.

Performance/Adherence Metrics

- Number and percentage of patients in the population of interest who undergo surgical debridement in the OR within 6-12 hours of arrival at Role 3 or 4 MTFs.
- Number and percentage of patients in the population of interest who have an operative note that quantifies the extent of wound necrosis as a percentage of each wound.

Data Sources

- Patient Record
- Department of Defense Trauma Registry (DoDTR)

System Reporting & Frequency

The above constitutes the minimum criteria for PI monitoring of this CPG. System reporting will be performed annually; additional PI monitoring and system reporting may be performed as needed.

The system review and data analysis will be performed by the JTS Chief and the JTS PI Branch.

Responsibilities

It is the trauma team leader’s responsibility to ensure familiarity, appropriate compliance, and PI monitoring at the local level with this CPG.