An evaluation of trauma team response in a major trauma hospital in 100 patients with predominantly minor injuries.
BACKGROUND
A prospective study of trauma team response and performance at a major trauma service was undertaken between June and September 1998.


METHODS
Following activation of the trauma team, the timing of the trauma team's arrival, the subsequent early management of the patient, time to monitoring, X-ray investigation and procedures performed were documented.


RESULTS
The study evaluated 100 activations, 76% male, mean age 32 years and 65% were due to road trauma. The team leader, airway doctor and surgical registrar were present on patient arrival in 96%, 90% and 76% of cases, respectively. The airway, procedure and scribe nurses were present on patient arrival in 77%, 97% and 95% of cases, respectively. The radiographer was present in 69% of cases. Comparison between normal and after-hour response revealed little difference in medical and radiographer response, but the after-hour nurse response was significantly worse (P < 0.001). The median time to achieve electrocardiogram monitoring, blood pressure reading, and oxygen saturation tracing was 3 (range: 1-13), 4 (range: 2-20) and 3 (range: 1-21) min, respectively. Intravenous cannulation, phlebotomy and dispatch of bloods occurred at median times of 5 (range: 2-22), 6 (range: 3-23) and 17 (range: 7-40) min. The median times for intubation, chest tube and splintage of fracture were 10 (range: 3-19), 10 (range: 6-14) and 26 (range: 19-55) min, respectively.


CONCLUSIONS
The present study identified an excellent multidisciplinary trauma response and provides a template to improve performance in early trauma management.
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W H
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Trauma Department, Liverpool Hospital, New South Wales, Australia.
Kolkman
K
K
Seger
M
M
Sugrue
M
M
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D002406:Catheterization, Peripheral; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009741:Nursing Staff, Hospital; D010100:Oxygen / Q000097:blood; D010348:Patient Care Team / Q000458:organization & administration*; D018962:Phlebotomy; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors; D014193:Trauma Centers; D000078329:Workforce; D014947:Wounds and Injuries / Q000628:therapy*
D010100:Oxygen