The trauma call

Mercer, Simon; Kingston, Elizabeth V; Jones, Clinton

doi:10.1136/bmj.k2272

Cited by 16 publications

(5 citation statements)

References 23 publications

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“…This change represents an increase in inappropriate trauma team activations between 2013 and 2018. We presume that the ineffective communication between the pre-hospital and hospital care providers, and the dogmatic interpretation of the suggested anatomical, physiological, mechanical and other triggers for major trauma team activations are the root causes of inappropriate major trauma team activations 13,18 . Our findings suggest the need for a re-evaluation of pre-hospital trauma triage criteria and trauma team activation protocols at our major trauma centre 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…It employed a set of data from two sources-Aintree MTC, Liverpool, and Trauma Audit and Research Network (TARN). Firstly, data from Aintree MTC was used to quantify all trauma team activations 12,13 and surgical procedures performed. Secondly, a subsection of this trauma patient group was defined as having major trauma according to TARN criteria.…”

Section: Methodsmentioning

confidence: 99%

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A profile of a major trauma centre of North West England between 2011 and 2018

Lunevičius

Mesri

2021

Sci Rep

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This study examined the trends and patterns of major trauma (MT) activities, causes, mortality and survival at the Aintree Major Trauma Centre (MTC), Liverpool, between 2011 and 2018. The number of trauma team activations (TTAs) rose sharply over time (n = 699 in 2013; n = 1522 in 2018). The proportion of TTAs that involved MT patients decreased from 75.1% in 2013 to 67.4% in 2018. The leading cause of MT was a fall from less than 2 m (36%). There has been a fivefold increase in the overall number of trauma procedures between 2011 and 2018. Orthopaedic surgeons have performed 80% of operations (n = 7732), followed by neurosurgeons, oral and maxillofacial surgeons, and general trauma surgeons. Both types of fall (> 2 m and < 2 m) and road traffic accidents were the three leading causes of death during the study period. The observed mortality rates exceeded that of expected rates in years 2012, 2014, 2016 and 2017. The all-cause observed to expected mortality ratio was 1.08 between 2012 and 2018. A change in care for MT patients was not directly associated with improved survival, although the marginally ascending trend line in survival rates between 2012 and 2018 reflects a gradual positive change.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A profile of a major trauma centre of North West England between 2011 and 2018

Lunevičius

Mesri

2021

Sci Rep

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“…primary survey '<C> ABCD approach'). 13,14 The standard sequence of events and usual actions of the majority of the trauma team will be altered to some degree to meet the needs of the pregnant trauma patient (Table 1). Obstetric specialists must play a key role in the preparatory period to identify and discuss these issues with the wider team before the patient's arrival in the hospital.…”

Section: Trauma Callmentioning

confidence: 99%

Trauma during pregnancy

2021

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“…2 Over the last decade there has been a reorganisation of English trauma services 3 such that any patient who suffers traumatic injury, with a pre-defined mechanism and/or derangement of physiological parameters, 4 now bypasses non-specialist hospitals and is taken directly to a specialist regional Major Trauma Centre (MTC). 5 In the UK, data for trauma patients are prospectively collected locally and collated by the Trauma Audit and Research Network (TARN); however, not all patients who trigger a trauma call meet criteria for subsequent TARN data collection.…”

Section: Introductionmentioning

confidence: 99%

The impact of ‘unofficial trauma’ on a Major Trauma Centre: A service evaluation of accident and emergency department trauma team activations

Wright

Mercer

Morton

2020

Trauma

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Introduction Trauma remains a leading cause of death worldwide. In the UK, data for trauma patients are prospectively collected locally and collated by the Trauma Audit and Research Network. This study assesses and describes the subgroup of patients who triggered a trauma call but who subsequently did not meet criteria for Trauma Audit and Research Network. Methods A single centre, retrospective observational study of trauma calls between 1 June 2012 and 31 August 2018 was performed, determining which trauma calls had been submitted to Trauma Audit and Research Network by cross referencing with the submission database. Data were tested for normality (Shapiro–Wilk test) and appropriate statistical tests employed to determine differences between inclusion and non-inclusion groups. For categorical data, we used Chi-squared tests to examine for differences. Results There were 6529 trauma calls and over half (3837 (58.8%)) were not registered on Trauma Audit and Research Network. Patients excluded were significantly younger (mean 42.4 years SD 19.2) than those who met inclusion criteria (mean 50.3 years, SD 21.8), p < 0.001 and were significantly more likely to suffer from penetrating trauma (18.6% versus 8.2%, p < 0.001), the majority (77.8%, 553/713) caused by stabbings. Patients excluded were less likely to be involved in a road traffic accident (31.1% versus 35.3%, p < 0.001), less likely to have fallen downstairs (15.2% versus 18.7%, p < 0.001) and less likely to have fallen from a height > 2 m (8.1% versus 12.7%, p < 0.001). Discussion Patients who trigger a trauma call but who subsequently do not meet the criteria for Trauma Audit and Research Network inclusion place a significant burden on healthcare provision. To our knowledge this is the first investigation to specifically explore this group of at-risk patients. To enable medical planners a more accurate view of activity on the ‘shop floor’, particularly in reference to knife crime injuries we ask the question as to whether a separate database should now be held of trauma calls?

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The trauma call

Cited by 16 publications

References 23 publications

A profile of a major trauma centre of North West England between 2011 and 2018

A profile of a major trauma centre of North West England between 2011 and 2018

Trauma during pregnancy

The impact of ‘unofficial trauma’ on a Major Trauma Centre: A service evaluation of accident and emergency department trauma team activations

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