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. 2021 Oct;47(5):1569-1580.
doi: 10.1007/s00068-020-01334-z. Epub 2020 Mar 2.

Survey on worldwide trauma team activation requirement

Christian Waydhas  1   2 , Heiko Trentzsch  3   4 , Timothy C Hardcastle  5 , Kai Oliver Jensen  6 ; World-Trauma TAcTIC Study Group
Collaborators, Affiliations

Survey on worldwide trauma team activation requirement

Christian Waydhas et al. Eur J Trauma Emerg Surg. 2021 Oct.

Abstract

Purpose: Trauma team activation (TTA) is thought to be essential for advanced and specialized care of very severely injured patients. However, non-specific TTA criteria may result in overtriage that consumes valuable resources or endanger patients in need of TTA secondary to undertriage. Consequently, criterion standard definitions to calculate the accuracy of the various TTA protocols are required for research and quality assurance purposes. Recently, several groups suggested a list of conditions when a trauma team is considered to be essential in the initial care in the emergency room. The objective of the survey was to post hoc identify trauma-related conditions that are thought to require a specialized trauma team that may be widely accepted, independent from the country's income level.

Methods: A set of questions was developed, centered around the level of agreement with the proposed post hoc criteria to define adequate trauma team activation. The participants gave feedback before they answered the survey to improve the quality of the questions. The finalized survey was conducted using an online tool and a word form. The income per capita of a country was rated according to the World Bank Country and Lending groups.

Results: The return rate was 76% with a total of 37 countries participating. The agreement with the proposed criteria to define post hoc correct requirements for trauma team activation was more than 75% for 12 of the 20 criteria. The rate of disagreement was low and varied between zero and 13%. The level of agreement was independent from the country's level of income.

Conclusions: The agreement on criteria to post hoc define correct requirements for trauma team activation appears high and it may be concluded that the proposed criteria could be useful for most countries, independent from their level of income. Nevertheless, more discussions on an international level appear to be warranted to achieve a full consensus to define a universal set of criteria that will allow for quality assessment of over- and undertriage of trauma team activation as well as for the validation of field triage criteria for the most severely injured patients worldwide.

Keywords: Field triage; Overtriage; Trauma team; Trauma team activation.

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Conflict of interest statement

There were no financial and personal relationships with other people or organizations to disclose by any of the authors.

Figures

Fig. 1
Fig. 1
Distribution of full agreement with criterion in relation to the countries’ income level. The vertical line denominates 75%—the level of agreement
Fig. 2
Fig. 2
Distribution of disagreement with criterion in relation to the countries’ income level
See this image and copyright information in PMC

References

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