title: [Interface between preclinical and clinical trauma care: Analysis of the processes in a trauma network].
abstract: BACKGROUND
  In the initial treatment of severely injured patients a good cooperation of the emergency medical service (EMS) with the hospital team is mandatory. The aim of this investigation was to evaluate the quality of cooperation between hospitals working within a trauma network and the rescue service and to develop a tool allowing assessment of the preclinical and clinical interface.
  
  
  METHODS
  Specific surveys concerning preclinical management and transfer to the target hospital were developed within a modified Delphi process. Injured trauma patients were included if the EMS involved was participating in the network and they were transferred to one of the participating hospitals.
  
  
  RESULTS
  Over an 11-month period a total of 360 patients were included in the study. The notification of transferring injured patients to the target hospital was carried out in a regular manner. Transport accompanied by an emergency physician occurred in 97% of the cases and no emergency physician was available although needed in only 1% of cases. Correct choice of target hospital was documented in 98.2%. The average waiting time for transferring the patient to the hospital team was 0.15 min. In 95.7% of cases a hospital physician was available to directly receive the patient in the emergency room. On a scale ranging from 1 (poor) to 10 (very good) clinical personnel as well as rescue teams rated the cooperation between both with a median of 10 points (IQR 8;10). From the clinicians point of view airway and circulation problems and external bleeding were correctly treated in the preclinical setting (airway 93.9%, circulation 97.3% and external bleeding 95.3%); however, for extremity injuries only in 78.5% of the cases.
  
  
  CONCLUSIONS
  This survey presents an adequate tool to identify weak spots within the primary management and to point out elements for improvement.
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Deutschland.
authors.forename: A O
authors.initials: AO
authors.lastname: Paul
authors.forename: S
authors.initials: S
authors.lastname: Poloczek
authors.forename: C
authors.initials: C
authors.lastname: Güthoff
authors.forename: M
authors.initials: M
authors.lastname: Richter
authors.forename: A
authors.initials: A
authors.lastname: Ekkernkamp
authors.forename: G
authors.initials: G
authors.lastname: Matthes
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data*; D015995:Prevalence; D017064:Process Assessment, Health Care; D014194:Traumatology / Q000706:statistics & numerical data*; D014850:Waiting Lists; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*