[When should the trauma team be activated?].
BACKGROUND
On admission to hospital, severely injured patients should be received by a trauma team so that the prospects of early life-saving treatment are not precluded. Considerations about use of resources indicate that the team is not activated when the likelihood of serious injury is low. A recommendation with criteria for activation of the trauma team has been established at the University Hospital of North Norway. We have studied how the recommendations were followed and calculated over- and under-triage and to highlight the question of whether activation should rather be automatically implemented based on predefined criteria.


METHODS
We use descriptive statistics to analyse compliance with the recommendation as well as pre- and intra-hospital data for trauma patients who prior to admission were recognised as having fulfilled the criteria.


RESULTS
Of the 109 trauma victims who, according to the recommendation, from 1 June 2001 to 31 May 2002 should have been received by the trauma team, 59 were received by a surgeon alone. Given that all patients with an injury severity score of 16 or more should be received by a trauma team, under-utilisation of the team was 50%, whereas the proportion of excess calls was 58%. Elimination of under-utilisation among this group of patients would, by strict adherence to the criteria, have conferred a very modest increase in the proportion of superfluous calls to 61%.


CONCLUSIONS
The trauma team should be activated automatically in accordance with predefined criteria.
Krüger
Andreas J
AJ
Det medisinske fakultet, Universitetet i Tromsø, 9037 Tromsø. andrejk@student.uit.no
Hesselberg
Nina
N
Abrahamsen
Geir Tore
GT
Bartnes
Kristian
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009664:Norway; D010348:Patient Care Team / Q000458:organization & administration / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D014218:Triage; D000078329:Workforce; D014947:Wounds and Injuries / Q000175:diagnosis*