Effectiveness of a 2-Specialty, 2-Tiered Triage and Trauma Team Activation Protocol☆,☆☆,★
Section snippets
INTRODUCTION
Injuries constitute the greatest threat to life for individuals younger than 45 years of age. Each year approximately 70 million people suffer an injury and 140,000 die as the result of their injuries.1 Even though it is well established that outcome in severely injured patients is improved by rapid transport to a Level I trauma center, trauma centers often care for a large number of less seriously injured patients as well.2, 3, 4, 5 Therefore it is important that the resources of trauma
MATERIALS AND METHODS
We conducted a retrospective analysis of a 2-specialty, 2-tiered trauma team activation system over a 6-month period at our ACS-verified Level I adult trauma center with pediatric commitment, which serves a population in excess of 2 million people. Evaluation and resuscitation occurs jointly by the departments of surgery and emergency medicine. Patients are classified as either category 1 (high likelihood of serious injury) or category 2 (low likelihood of serious injury) using a triage
RESULTS
During the 6-month study period, 561 patients fulfilled criteria for categorization. Of these, 272 (48.5%) were classified as category 1 and 289 (51.5%) were in category 2. Demographic data are shown in Table 1.Characteristic Category 1 (n=272) No. (%) Category 2 (n=289) No. (%) Male 186 (68%) 201 (70%) Mean age (y±SD) 35.9±17.8 34.5±20.1 Penetrating injury 63 (23%) 3 (1%)* * P <.0001.
DISCUSSION
Trauma team activation is tied directly to prehospital triage. The ACS Committee on Trauma recommends that guidelines used to judge the seventy of injury and need for trauma center care must address the following: (1) abnormal physiologic signs, (2) obvious anatomic injury, (3) mechanism of injury, and (4) concurrent disease.2 Physiologic abnormalities were the first parameters chosen for field triage because they were most easily quantified. Although abnormal physiology is a very specific
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Cited by (32)
The performance of trauma team activation criteria at an Australian regional hospital
2019, InjuryCitation Excerpt :Initial care by such a "Trauma Team" may improve outcomes for patients who have suffered severe injuries [1,2]. In seeking to maximise the benefit of hospital behaviour at the population level, the benefit to severely injured trauma patients is balanced against the effect of removing resources from other areas [3,4]. This balance is unlikely to be the same in every trauma centre.
Emergency Department Trauma Redesign in a Level 1 Trauma Centre
2011, Australasian Emergency Nursing JournalProspective evaluation of a two-tiered trauma activation protocol in an Australian major trauma referral hospital
2010, InjuryCitation Excerpt :The generalisation of these studies to the Australian trauma population is possibly misleading. The Australian trauma population is different with much lower rates of penetrating trauma (4.5% in this study compared with 9–47% in American studies2,10,11,16). The Australian trauma system is also different.
Do trauma teams make a difference?. A single centre registry study
2007, ResuscitationCitation Excerpt :Trauma systems involve a multitude of different prehospital and hospital based components, each of which contributes in varying degrees of importance to improving patient care.6–12 When a severely injured trauma patient arrives in hospital, one important aspect of a good trauma system is the early and rapid assembly of experienced clinical decision makers who can plan and implement early life and limb saving procedures.13–19 Multiple levels for trauma team activation have been described, according to individual systems’ triage protocols, but whichever system is used, a trauma team is assembled in the trauma resuscitation room in response to a trauma activation call.
Is There Evidence to Support the Need for Routine Surgeon Presence on Trauma Patient Arrival?
2006, Annals of Emergency Medicine
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From the Departments of Surgery,* Emergency Medicine,‡ and Pediatrics,§ Case Western Reserve University School of Medicine, MetroHealth Medical Center Campus, Cleveland, OH.
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Reprint no. 47/1/92999
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Reprints not available from the authors.