title: Evaluation of a trauma team activation protocol revision: a prospective cohort study.
abstract: BACKGROUND
  Correct triage based on prehospital information contributes to a better outcome for potentially seriously injured patients. In 2011 we changed the trauma team activation (TTA) criteria in our center in order to improve the high over- and undertriage properties of the protocol. Five criteria that were unable to predict severe injury were removed. In the present study, we evaluated the protocol revision by comparing over- and undertriage in the former and present set of criteria.
  
  
  METHODS
  All severely injured patients (Injury Severity Score (ISS) > 15) and all patients admitted with TTA in the period of 01.01.2013 - 31.12.2014 were included in the study. We defined overtriage as the fraction of patients with TTA when ISS ≤15 and undertriage as the fraction of patients without TTA when ISS > 15. We also evaluated triage with the occurrence of emergency procedures immediately after admission.
  
  
  RESULTS
  324 patients were included, 164 patients had ISS>15, 287 were admitted with TTA. Over- and undertriage were 74 % and 28 % respectively. When we used emergency procedure as reference, the figures were 83 % and 15 % respectively. Undertriaged patients had significantly more neurosurgical injuries and were significantly more often transferred from an acute care hospital.
  
  
  CONCLUSIONS
  Over- and undertriage are almost the same as before the criteria were revised, and higher thanrecommended levels.
  
  
  CONCLUSIONS
  Revision of the TTA criteria has not improved triage, and further measures are necessary to achieveacceptable levels.
authors: Department of Gastrointestinal Surgery, University Hospital North Norway (UNN), 9038, Tromsø, Norway. trond.dehli@gmail.com.|Department of Clinical Medicine, UiT- The Arctic University of Norway, 9037, Tromsø, Norway. trond.dehli@gmail.com.
authors: Trond
authors: http://orcid.org/0000-0001-7709-9385
authors: T
authors: Dehli
authors: Department of Anesthesiology, Helgeland Hospital, 8801, Sandnessjøen, Norway.
authors: Svein Arne
authors: SA
authors: Monsen
authors: Department of Clinical Medicine, UiT- The Arctic University of Norway, 9037, Tromsø, Norway.|Division of Emergency Medical Services, UNN, 9038, Tromsø, Norway.
authors: Knut
authors: K
authors: Fredriksen
authors: Department of Clinical Medicine, UiT- The Arctic University of Norway, 9037, Tromsø, Norway.|Department of Cardiothoracic and Vascular Surgery, UNN, 9038, Tromsø, Norway.
authors: Kristian
authors: K
authors: Bartnes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010360:Patient Transfer; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers; D014218:Triage / Q000379:methods*; D055815:Young Adult
keywords: Emergency treatment; Patient transfer; Trauma; Triage