Difference in trauma team activation criteria between hospitals within the same region

Smith, Jessi L.; Caldwell, Erica; Sugrue, Michael

doi:10.1111/j.1742-6723.2005.00780.x

Cited by 22 publications

(20 citation statements)

References 28 publications

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“…Studies from Great Britain, Denmark, and Australia have shown wide variation with respect to TTA criteria within the same country and region, despite comparable trauma populations [32-34]. As evident in our study, it is not clear why hospitals choose different "cut-offs", but tradition rather than evidence was cited as a possible explanation [30,31].…”

Section: Discussionmentioning

confidence: 60%

Differences in trauma team activation criteria among Norwegian hospitals

Larsen

Uleberg

Skogvoll

2010

Scand J Trauma Resusc Emerg Med

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BackgroundTo ensure the rapid and correct triage of patients in potential need of specialized treatment, Norwegian hospitals are expected to establish trauma teams with predefined criteria for their activation. The objective of this study was to map and describe the criteria currently in use.MethodsWe undertook a cross-sectional survey in the summer of 2008, using structured telephone interviews to all Norwegian hospitals that might admit severely injured patients.ResultsForty-nine hospitals were included, of which 48 (98%) had a trauma team and 20 had a hospital-based trauma registry. Criteria for trauma team activation were found at 46 (94%) hospitals. No single criterion was common to all hospitals. The median number of criteria per hospital was 23 (range 8-40), with a total number of 156 and wide variation with respect to physiological "cut-off" values. The mechanism of injury was commonly in use despite a well-known, large over-triage rate.ConclusionsIn recent years, Norwegian hospitals have gradually established trauma teams and criteria for their activation. These criteria show considerable variation, including physiological "cut-off" values.

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Section: Discussionmentioning

confidence: 60%

Differences in trauma team activation criteria among Norwegian hospitals

Larsen

Uleberg

Skogvoll

2010

Scand J Trauma Resusc Emerg Med

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“…Even if the paediatric patient is ambulatory at scene with normal physiology and minor or no apparent injury, if the treating paramedic is in doubt, they are to transport the child to a trauma centre. Although this results in over‐triage, given the comparatively small incidence of paediatric trauma in Australia, it could be asserted that over‐triage can have the positive effect of facilitating trauma team training . Major trauma presentations comprise an extremely small percentage of overall emergency department (ED) presentations in the majority of hospitals, with injury overall accounting for 6% of the 6.7 million Australian ED presentations in 2006–2007…”

Section: Discussionmentioning

confidence: 99%

Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia

Mitchell

Curtis

Holland

et al. 2013

J Paediatrics Child Health

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“…Surveys demonstrate that significant variation exists among the composition and activation criteria for trauma teams outside of the United States 3,4. Such variation is not known to occur within the U.S. but is highly likely.…”

Section: Discussionmentioning

confidence: 99%

“…Criteria for internal trauma team activation and degree of response vary by hospital 3,4. Limited data exist for determining appropriate internal trauma team response 5–12.…”

Section: Introductionmentioning

confidence: 99%

Does Young Age Merit Increased Emergency Department Trauma Team Response?

Holmes¹,

Caltagirone²,

Murphy³

et al. 2013

WestJEM

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Introduction:To determine if increased trauma team response results in alterations in resource use in a population of children <6 years, especially in those least injured.Methods:We conducted a retrospective before and after study of children <6 years sustaining blunt trauma and meeting defined prehospital criteria. We compared hospitalization rates and missed injuries (injuries identified after discharge from the emergency department/hospital) among patients with and without an upgraded trauma team response. We compared the computed tomography (CT) rate and laboratory testing rate among minimally injured patients (Injury Severity Score [ISS] 6).Results:We enrolled 352 patients with 180 (mean age 2.7 ± 1.5 years) in the upgrade cohort and 172 (mean age 2.6 ± 1.5 years) in the no-upgrade cohort. Independent predictors of hospital admission in a regression analysis included: Glasgow Coma Scale <14 (odds ratio [OR]=11.4, 95% confidence interval [CI] 2.3, 56), ISS (OR=1.55, 95% CI 1.33, 1.81), and evaluation by the upgrade trauma team (OR=5.66, 95% CI 3.14, 10.2). In the 275 patients with ISS <6, CT (relative risk=1.34, 95% CI 1.09, 1.64) and laboratory tests (relative risk=1.71, 95% CI 1.39, 2.11) were more likely to be obtained in the upgrade cohort as compared to the no-upgrade cohort. We identified no cases of a missed diagnosis.Conclusion:Increasing the trauma team response based upon young age results in increased resource use without altering the rate of missed injuries. In hospitals with emergency department physicians capable of evaluating and treating injured children, increasing ED trauma team resources solely for young age of the patient is not recommended.

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Difference in trauma team activation criteria between hospitals within the same region

Cited by 22 publications

References 28 publications

Differences in trauma team activation criteria among Norwegian hospitals

Differences in trauma team activation criteria among Norwegian hospitals

Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia

Does Young Age Merit Increased Emergency Department Trauma Team Response?

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