Trauma team leaders in Canada: A national survey

Abstract

Introduction The availability, composition and activation criteria for trauma teams vary across different health care systems, but little is known about these features in the Canadian health system. The aim of this study is to provide a description of the current trauma team available in Level 1 and 2 centres across Canada. Methods In 2017, using a modified Dillman technique, a survey was sent to 210 health professionals across all Canadian trauma care facilities, including questions that focused on (1) the presence and the composition of a trauma team, (2) the established criteria to activate this team and (3) the initial patient care. Results Overall, 107 (57%) completed surveys were received. Only 22 (11.7%) were from Level 1 or 2 centre and considered for compilation. Seventeen respondents have a trauma team in their centre, and they all shared their criteria for activating their team (1–27 different indications). The suspected injuries, the judgment of the emergency physician, the systolic blood pressure, the Glasgow Coma Score and the respiratory rate were the most frequently mentioned items. In the presence of a pre-hospital care warning, the initial assessment of a severely injured patient is exclusively completed by a member of the trauma team for only 35.1% of the respondents. For 11.8% of respondents, trauma team coordinates airway management. For 64.7% of participants, the trauma team leader is the dedicated care provider to accompany patients until the final destination. Conclusions The results suggest a great variability across Canada, regarding the roles assumed by the trauma team but also regarding the activation criteria leading them to take action.

Trauma teams in Aotearoa New Zealand—a national survey

“…13 The rate of trauma team utilisation is higher than many other countries where the rates vary from 21% to 98%. 10,[14][15][16][17][18][19][20] This may reflect the well-developed trauma systems in place within New Zealand. 21 Future research may be able to provide comparisons with countries that have lower trauma team utilisation and major trauma outcomes to determine potential benefit to this high rate.…”

“…Penetrating injury to the head, neck or torso 95 (20) Major burns >20% in adults (>10% in paeds), or airway burns 86 (18) Known or suspected spinal cord injury (paraplegia or quadriplegia) 71 (15) Major crush injury 66 (14) Suspected complex pelvic injury 57 (12) Two or more proximal long bone fractures 57 (12) Flail chest 52 (11) Airway obstruction 48 (10) Traumatic limb amputation 43 (9) Trauma to a limb with arterial injury 9. major trauma centre (2/7) and too few trauma patients (2/7). Just over half (57%) recognised that the formation of a trauma team at their facility may positively impact patient outcomes, and 57% also identified potential benefits for the centre at which they work if there were not the barriers as mentioned earlier with workforce issues.…”

Rehabilitation after musculoskeletal injury: an overview of systems in the United States and Canada

“…The trauma team comprises a multidisciplinary team lead by the trauma team leader (TTL). 29,30 Composition is variable, but typically, general surgery and anesthesia are core members. Orthopaedics is part of the trauma team in some institutions.…”