Trauma teams

Brooks, Adam; Burton, T. L.; Williams, James; Mahoney, Peter F.

doi:10.1177/146040860100300403

Cited by 8 publications

(16 citation statements)

References 17 publications

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“…This study found that most Dutch EDs use a one-team trauma triage system, although a large variation was found in size and composition of trauma teams and the TTA process. Our results are largely consistent with the local variation found in several international studies on TTA [ 2 , 4 , 5 , 14 , 17 – 21 ]. Nonetheless, this is somewhat surprising considering that the quality improvement activities for trauma care in the Netherlands since 1997 [ 22 , 24 ] and the existence of national guidelines [ 23 , 25 , 26 , 29 ] should suggest a more uniform TTA.…”

Section: Discussionsupporting

confidence: 92%

“…Overtriage obviously is costly and may be considered an inefficient use of staff and resources [ 6 , 14 ]. Internationally, size and composition of trauma teams and the process and criteria for in-hospital TTA are reported to vary on a local basis depending on resources, experience and level of adoption [ 2 , 4 , 5 , 14 , 17 – 21 ]. A system with a tiered-response has been shown to contribute to a safe and efficient TTA by reducing the amount of resources required and by improving patient outcomes, but may be inappropriate in EDs with a low number of trauma patients or with less experience in trauma care [ 4 , 6 – 8 , 10 – 14 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Trauma team activation varies across Dutch emergency departments: a national survey

Egberink

Otten

IJzerman

et al. 2015

Scand J Trauma Resusc Emerg Med

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BackgroundTiered 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).MethodsA survey was conducted among managers of all 102 EDs in the Netherlands, using a semi-structured online questionnaire.ResultsSeventy-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.ConclusionsTrauma 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-015-0185-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Trauma team activation varies across Dutch emergency departments: a national survey

Egberink

Otten

IJzerman

et al. 2015

Scand J Trauma Resusc Emerg Med

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“…In the flow of teamwork created through online commentary, the team itself is consolidated through shared understandings and shared tasks. Additionally, online commentary creates a rich informational context in which team leaders who, ideally, remain at a "monitoring distance" from the direct action, 28 are fully informed in the same way as other team members, but can maintain the kind of overall view that is required to direct, or redirect, the work of the team.…”

Section: Resultsmentioning

confidence: 99%

Online Commentary in Primary Care and Emergency Room Settings

Heritage

2016

Acute Medicine & Surgery

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This paper describes a communication practice called “online commentary” that is in widespread use in primary care in the USA. Online commentary is talk by a clinician that describes what he or she is finding in the course of the physical examination of the patient. The paper reviews the primary features of online commentary, with a special focus on its role in forecasting the likely results of the physical examination during the examination itself. It also describes patient outcomes that are associated with this use. It then uses data from an emergency room in the western USA to extend the notion of online commentary from primary care to the emergency setting. It proposes that online commentary facilitates effective teamwork by forecasting next actions, allowing members of the emergency team to anticipate probable next steps in the investigation and treatment of patient injuries.

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“…Several studies have shown that the introduction of trauma teams decreases the time to life saving procedures, improves the standard of care and significantly reduces mortality in moderate and severe injuries (Brooks et al, 2001). Several studies have shown that the introduction of trauma teams decreases the time to life saving procedures, improves the standard of care and significantly reduces mortality in moderate and severe injuries (Brooks et al, 2001).…”

Section: Hospital Carementioning

confidence: 99%

Global trends in trauma

2004

Trauma

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Injuries cause about 10% of all deaths worldwide, with road traffic accidents, selfinflicted injuries, violence and war injuries being the most common causes of traumatic deaths. There is an anticipated increase in all of these categories by the year 2020. In addition to the increasing global incidence of trauma, other major trends in trauma and its management identified in this review include the growing emphasis on prevention and public health aspects of trauma, the globalization of trauma practices due to the rapid access to new information, a critical emphasis on organizational aspects of trauma care and education, the prominent role of efficacious and cost effective management practises, a shift to gentler treatment methods with less interference in the physiological recovery mechanisms, and at the same time, extreme care and the management of its consequences. In order to fight the global epidemic of trauma, it is the duty and the privilege of health care professionals to take the leadership in this task by 'thinking globally and acting locally ' but most importantly by working together and sharing their experiences (the successes and the failures) and by knowing that they can make a difference.

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Trauma teams

Cited by 8 publications

References 17 publications

Trauma team activation varies across Dutch emergency departments: a national survey

Trauma team activation varies across Dutch emergency departments: a national survey

Online Commentary in Primary Care and Emergency Room Settings

Global trends in trauma

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