Trauma Team Activation Can Be Tailored by Prehospital Criteria

A two phase prospective study was carried out at a regional Level I trauma center over 1 year. Phase I involved collecting observational data to determine which trauma criteria could potentially be used to identify patients that could be evaluated by a lower level trauma activation (category-3). A c...

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Bibliographic Details
Published in:The American surgeon 2010-12, Vol.76 (12), p.1401-1407
Main Authors: CLARIDGE, Jeffrey A, GOLOB, Joseph F, LEUKHARDT, William H, KAN, Justin A, COMO, John J, MALANGONI, Mark A, YOWLER, Charles J
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Biological and medical sciences
Clinical Protocols
Efficiency, Organizational
Emergency medical care
Emergency services
Female
General aspects
Glasgow Coma Scale
Hospitals
Humans
Male
Medical sciences
Ohio
Patient safety
Patient satisfaction
Prospective Studies
Trauma centers
Triage - organization & administration
Triage - standards
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Summary:A two phase prospective study was carried out at a regional Level I trauma center over 1 year. Phase I involved collecting observational data to determine which trauma criteria could potentially be used to identify patients that could be evaluated by a lower level trauma activation (category-3). A category-3 involved a smaller response team with priority access to imaging. Phase II involved implementing this third tier activation system and prospectively evaluating the outcomes related to resources and patient care. A total of 3104 patients were evaluated with 2076 patients in phase I and 1037 in phase II. Three commonly identified activation criteria out of the 36 studied were not associated with admission. These criteria were pedestrian struck by vehicle, high speed vehicular crash, and Glasgow Coma Score 12-14. These criteria were then used as triggers for a category-3 activation in phase II. Comparisons of patients with these three identified criteria between phase I and II demonstrated that significantly fewer patients were admitted, charges were reduced, emergency department times were similar, and less man-power hours were needed in phase II. The utilization of a third tiered activation system resulted in a decrease utilization of many resources without sacrificing patient care.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481007601227