Better compliance with triage criteria in trauma would reduce costs with maintained patient safety

Linder, Fredrik; Holmberg, Lina; Eklöf, Hampus; Björck, Martin; Juhlin, Claes; Mani, Kevin

doi:10.1097/mej.0000000000000544

Cited by 22 publications

(15 citation statements)

References 16 publications

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“…79 Efforts have been made to evaluate compliance of criteria with over and under triage, and also to see if criteria are accurate to identify patients in need of full trauma team activation. 64 We agree with Lossius et al 13 that consensus on uniform definitions in trauma research should be established to facilitate comparability in trauma research. In Sweden, consensus-based new national criteria for trauma team activation (TTA) was developed in 2016, by an expert panel with the support of a Swedish public insurance company (LÖF).…”

Section: Triagesupporting

confidence: 75%

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Patient experiences of initial trauma care

Granström

Strömmer²,

Falk

et al. 2019

International Emergency Nursing

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Section: Triagesupporting

confidence: 75%

“…Calculation of over-and under triage rates are referred to as Matrix, Cribari or modified Matrix. 7,12,64,65 Calculations were performed according to the intention to treat principle.…”

Section: Study Imentioning

confidence: 99%

Patient experiences of initial trauma care

Granström

Strömmer²,

Falk

et al. 2019

International Emergency Nursing

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“…“Time is life, time is speed” explains the general requirements of traumatology. 17 , 18 It consist of a correct and effective treatment in the shortest time, especially the first aid, injury assessment, preoperative examination and preparation in the shortest time. 19 , 20 …”

Section: Discussionmentioning

confidence: 99%

Application of trauma time axis management in the treatment of severe trauma patients

Wang

Chen

Ling

et al. 2021

Chinese Journal of Traumatology

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Purpose This study aimed at exploring the application of trauma time axis management in the treatment of severe trauma patients by using the Medicalsystem trauma system. Methods We performed a retrospective cohort study involving patients with severe trauma. Patients who were admitted before the application of the Medicalsystem trauma system were divided into before system group; patients who were admitted after the application of the system were divided into after system group. Comparison was made between the two groups. For normally distributed data, means were reported along with standard deviation, and comparisons were made using the independent samples t test. Categorical data were compared using the Chi-square test. The Mann-Whitney U test was used to compare nonparametric variables. Results There were 528 patients admitted to the study during the study period. There was no significant statistical difference in the time from the start of trauma team to arrive at the resuscitation room between the two groups. The time from arrival at hospital to endotracheal intubation, to ventilator therapy, to blood transfusion, to completion of CT scan, to completion of closed thoracic drainage, to the start of operation, as well as the length of stay in resuscitation room and hospital were significantly lower after the application of the Medicalsystem trauma system. The mortality was decreased by 8.6% in the after system group compared with that in the before system group, but there was no statistical difference. Conclusion The Medicalsystem trauma system can optimize diagnosis and treatment process for trauma patients, and accordingly improve the treatment efficiency and shorten the treatment time. Therefore, the Medicalsystem trauma system deserves further popularization and promotion.

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“…To measure the quality of trauma team activation some post hoc definition is necessary to define, whether the activation of a trauma team was correct or not. Many researchers and quality controllers use the Injury Severity Score (ISS) alone, to differentiate between patients who require a trauma team (ISS ≥ 16) or not (ISS < 16) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. ISS is fairly easy to calculate, can be automatically retrieved from electronic records and it appears self-evident that a higher injury severity correlates with worse outcome and that more severely injured patients may benefit from a specialized trauma team.…”

Section: Introductionmentioning

confidence: 99%

ISS alone, is not sufficient to correctly assign patients post hoc to trauma team requirement

Waydhas

Bieler

Hamsen

et al. 2020

Eur J Trauma Emerg Surg

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Purpose An injury severity score (ISS) ≥ 16 alone, is commonly used post hoc to define the correct activation of a trauma team. However, abnormal vital functions and the requirement of life-saving procedures may also have a role in defining trauma team requirement post hoc. The aim of this study was to describe their prevalence and mortality in severely injured patients and to estimate their potential additional value in the definition of trauma team requirement as compared to the definition based on ISS alone. Methods Retrospective analysis of a trauma registry including patients with trauma team activation from the years 2009 until 2015, who were 16 years of age or older and were brought to the trauma center directly from the scene. Patients were divided into a group with an ISS ≥ 16 vs. ISS < 16. For analysis a predefined list of abnormal vital functions and life-saving interventions was used. Results 58,723 patients were included in the study (N = 32,653 with ISS ≥ 16; N = 26,070 with ISS < 16). From the total number of patients that required life-saving procedures or presented with abnormal vital functions 29.1% were found in the ISS < 16 group. From the ISS < 16 group, 36.7% of patients required life-saving procedures or presented with abnormal vital signs. The mortality of those was 8.1%. Conclusions Defining the true requirement of trauma team activation post hoc by using ISS ≥ 16 alone does miss a considerable number of subjects who require life-saving interventions or present with abnormal vital functions. Therefore, life-saving interventions and abnormal vital functions should be included in the definitions for trauma team requirement. Further studies have to evaluate, which life-saving procedures and abnormal vital functions are most relevant.

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Better compliance with triage criteria in trauma would reduce costs with maintained patient safety

Cited by 22 publications

References 16 publications

Patient experiences of initial trauma care

Patient experiences of initial trauma care

Application of trauma time axis management in the treatment of severe trauma patients

ISS alone, is not sufficient to correctly assign patients post hoc to trauma team requirement

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