title: Trauma team activation varies across Dutch emergency departments: a national survey.
abstract: BACKGROUND
  Tiered trauma team response may contribute to efficient in-hospital trauma triage by reducing the amount of resources required and by improving health outcomes. This study evaluates current practice of trauma team activation (TTA) in Dutch emergency departments (EDs).
  
  
  METHODS
  A survey was conducted among managers of all 102 EDs in the Netherlands, using a semi-structured online questionnaire.
  
  
  RESULTS
  Seventy-two questionnaires were analysed. Most EDs use a one-team system (68 %). EDs with a tiered-response receive more multi trauma patients (p < 0.01) and have more trauma team alerts per year (p < 0.05) than one-team EDs. The number of trauma team members varies from three to 16 professionals. The ED nurse usually receives the pre-notification (97 %), whereas the decision to activate a team is made by an ED nurse (46 %), ED physician (30 %), by multiple professionals (20 %) or other (4 %). Information in the pre-notification mostly used for trauma team activation are Airway-Breathing-Circulation (87 %), Glasgow Coma Score (90 %), and Revised Trauma Score (85 %) or Paediatric Trauma Score (86 %). However, this information is only available for 75 % of the patients or less. Only 56 % of the respondents were satisfied with their current in-hospital trauma triage system.
  
  
  CONCLUSIONS
  Trauma team activation varies across Dutch EDs and there is room for improvement in the trauma triage system used, size of the teams and the professionals involved. More direct communication and more uniform criteria could be used to efficiently and safely activate a specific trauma team. Therefore, the implementation of a revised national consensus guideline is recommended.
authors.affiliation: Acute Zorg Euregio, PO Box 50.000, 7500, KA, Enschede, The Netherlands. r.e.egberink@utwente.nl.|Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands. r.e.egberink@utwente.nl.
authors.forename: Rolf E
authors.initials: RE
authors.lastname: Egberink
authors.affiliation: Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands. harmjanotten@gmail.com.
authors.forename: Harm-Jan
authors.initials: HJ
authors.lastname: Otten
authors.affiliation: Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands. m.j.ijzerman@utwente.nl.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: IJzerman
authors.affiliation: Emergency Department, Medisch Spectrum Twente, PO Box 50.000, 7500, KA, Enschede, The Netherlands. a.vanvugt@mst.nl.
authors.forename: Arie B
authors.initials: AB
authors.lastname: van Vugt
authors.affiliation: Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands. c.j.m.doggen@utwente.nl.
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: Doggen
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013997:Time Factors; D015599:Trauma Severity Indices; D014218:Triage