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Differences in trauma team activation criteria among Norwegian hospitals.

Larsen KT, Uleberg O, Skogvoll E - Scand J Trauma Resusc Emerg Med (2010)

Bottom Line: 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.These criteria show considerable variation, including physiological "cut-off" values.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

ABSTRACT

Background: To 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.

Methods: We undertook a cross-sectional survey in the summer of 2008, using structured telephone interviews to all Norwegian hospitals that might admit severely injured patients.

Results: Forty-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.

Conclusions: In 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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Distribution of values for fall height (m) when used as a criterion for trauma team activation.
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Figure 5: Distribution of values for fall height (m) when used as a criterion for trauma team activation.

Mentions: As an independent criterion, mechanism of injury (MOI) was employed by 38 hospitals (83%) as a reason for activation of the full trauma team. "Fall injury" was the most frequently used criterion and was used in all of these hospitals (but with varying heights; Figure 5). Two hospitals used two heights simultaneously: one used both 4 and 5 m; another both 5 m and/or three times the body length. "Thrown out of vehicle", "death of another individual involved in the accident", "prolonged extrication time", and "pedestrians or cyclists involved in the accident" were other frequent criteria. "Prolonged extrication time" with different specified durations were found in four hospitals. Further, various mechanisms and speeds were used for the criterion "motor vehicle accident" (Figure 6). "Damaged vehicle", "rollover", "crush injury", "explosion", and "avalanche", as well as other unspecific trauma scenes, were used as criteria at several hospitals. "Extreme sport accident" and "industrial accident" each occurred at only one hospital.


Differences in trauma team activation criteria among Norwegian hospitals.

Larsen KT, Uleberg O, Skogvoll E - Scand J Trauma Resusc Emerg Med (2010)

Distribution of values for fall height (m) when used as a criterion for trauma team activation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2874509&req=5

Figure 5: Distribution of values for fall height (m) when used as a criterion for trauma team activation.
Mentions: As an independent criterion, mechanism of injury (MOI) was employed by 38 hospitals (83%) as a reason for activation of the full trauma team. "Fall injury" was the most frequently used criterion and was used in all of these hospitals (but with varying heights; Figure 5). Two hospitals used two heights simultaneously: one used both 4 and 5 m; another both 5 m and/or three times the body length. "Thrown out of vehicle", "death of another individual involved in the accident", "prolonged extrication time", and "pedestrians or cyclists involved in the accident" were other frequent criteria. "Prolonged extrication time" with different specified durations were found in four hospitals. Further, various mechanisms and speeds were used for the criterion "motor vehicle accident" (Figure 6). "Damaged vehicle", "rollover", "crush injury", "explosion", and "avalanche", as well as other unspecific trauma scenes, were used as criteria at several hospitals. "Extreme sport accident" and "industrial accident" each occurred at only one hospital.

Bottom Line: 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.These criteria show considerable variation, including physiological "cut-off" values.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

ABSTRACT

Background: To 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.

Methods: We undertook a cross-sectional survey in the summer of 2008, using structured telephone interviews to all Norwegian hospitals that might admit severely injured patients.

Results: Forty-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.

Conclusions: In recent years, Norwegian hospitals have gradually established trauma teams and criteria for their activation. These criteria show considerable variation, including physiological "cut-off" values.

Show MeSH
Related in: MedlinePlus