Trauma team activation varies across Dutch emergency departments: a national survey

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Carine J. M. Doggen¹  Arie B. van Vugt²  Maarten J. IJzerman¹  Harm-Jan Otten¹  Rolf E. Egberink¹ 

[1] Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500, AE, The Netherlands;Emergency Department, Medisch Spectrum Twente, Enschede, 7500, KA, The Netherlands

关键词: Trauma team activation;    In-hospital trauma triage;    Emergency department;    Decision making;    Patient care team;    Triage;    Multiple trauma;    Emergency nursing;    Emergency service hospital;    Emergency medical services;   

Others  :  1235305
DOI  :  10.1186/s13049-015-0185-0

 received in 2015-07-04, accepted in 2015-11-12,  发布年份 2015

【 摘 要 】

Background

Tiered trauma team response may contribute to efficient in-hospital trauma triage by reducing the amount of resources required and by improving health outcomes. This study evaluates current practice of trauma team activation (TTA) in Dutch emergency departments (EDs).

Methods

A survey was conducted among managers of all 102 EDs in the Netherlands, using a semi-structured online questionnaire.

Results

Seventy-two questionnaires were analysed. Most EDs use a one-team system (68 %). EDs with a tiered-response receive more multi trauma patients (p < 0.01) and have more trauma team alerts per year (p < 0.05) than one-team EDs. The number of trauma team members varies from three to 16 professionals. The ED nurse usually receives the pre-notification (97 %), whereas the decision to activate a team is made by an ED nurse (46 %), ED physician (30 %), by multiple professionals (20 %) or other (4 %). Information in the pre-notification mostly used for trauma team activation are Airway-Breathing-Circulation (87 %), Glasgow Coma Score (90 %), and Revised Trauma Score (85 %) or Paediatric Trauma Score (86 %). However, this information is only available for 75 % of the patients or less. Only 56 % of the respondents were satisfied with their current in-hospital trauma triage system.

Conclusions

Trauma team activation varies across Dutch EDs and there is room for improvement in the trauma triage system used, size of the teams and the professionals involved. More direct communication and more uniform criteria could be used to efficiently and safely activate a specific trauma team. Therefore, the implementation of a revised national consensus guideline is recommended.

【 授权许可】

   
2015 Egberink et al.

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