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. 2016 Aug 25;24(1):105.
doi: 10.1186/s13049-016-0295-3.

Evaluation of a trauma team activation protocol revision: a prospective cohort study

Trond Dehli  1   2 , Svein Arne Monsen  3 , Knut Fredriksen  4   5 , Kristian Bartnes  4   6
Affiliations

Evaluation of a trauma team activation protocol revision: a prospective cohort study

Trond Dehli et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Correct triage based on prehospital information contributes to a better outcome for potentially seriously injured patients. In 2011 we changed the trauma team activation (TTA) criteria in our center in order to improve the high over- and undertriage properties of the protocol. Five criteria that were unable to predict severe injury were removed. In the present study, we evaluated the protocol revision by comparing over- and undertriage in the former and present set of criteria.

Methods: All severely injured patients (Injury Severity Score (ISS) > 15) and all patients admitted with TTA in the period of 01.01.2013 - 31.12.2014 were included in the study. We defined overtriage as the fraction of patients with TTA when ISS ≤15 and undertriage as the fraction of patients without TTA when ISS > 15. We also evaluated triage with the occurrence of emergency procedures immediately after admission.

Results: 324 patients were included, 164 patients had ISS>15, 287 were admitted with TTA. Over- and undertriage were 74 % and 28 % respectively. When we used emergency procedure as reference, the figures were 83 % and 15 % respectively. Undertriaged patients had significantly more neurosurgical injuries and were significantly more often transferred from an acute care hospital.

Discussion: Over- and undertriage are almost the same as before the criteria were revised, and higher thanrecommended levels.

Conclusions: Revision of the TTA criteria has not improved triage, and further measures are necessary to achieveacceptable levels.

Keywords: Emergency treatment; Patient transfer; Trauma; Triage.

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