What is optimal timing for trauma team alerts? A retrospective observational study of alert timing effects on the initial management of trauma patients

Abstract

BackgroundTrauma teams improve the initial management of trauma patients. Optimal timing of trauma alerts could improve team preparedness and performance while also limiting adverse ripple effects throughout the hospital. The purpose of this study was to evaluate how timing of trauma team activation and notification affects initial in-hospital management of trauma patients.MethodsData from a single hospital trauma care quality registry were matched with data from a trauma team alert log. The time from patient arrival to chest X-ray, and the emergency department length of stay were compared with the timing of trauma team activations and whether or not trauma team members received a preactivation notification.ResultsIn 2009, the trauma team was activated 352 times; 269 times met the inclusion criteria. There were statistically significant differences in time to chest X-ray for differently timed trauma team activations (P = 0.003). Median time to chest X-ray for teams activated 15–20 minutes prearrival was 5 minutes, and 8 minutes for teams activated <5 minutes before patient arrival. Timing had no effect on length of stay in the emergency department (P = 0.694). We found no effect of preactivation notification on time to chest X-ray (P = 0.474) or length of stay (P = 0.684).ConclusionProactive trauma team activation improved the initial management of trauma patients. Trauma teams should be activated prior to patient arrival.

Effect of private versus emergency medical systems transportation in trauma patients in a mostly physician based system- a retrospective multicenter study based on the TraumaRegister DGU®

“…The arrival of a patient with suspected severe injury by EMS is usually pre-announced in European countries and a team assembled in the trauma room, including specialists for Surgery, Anesthesiology and Radiology. Given the delay in diagnostic procedures, the lack of announcement may lead to a delay in alarming the team, as early trauma team activation leads to accelerated diagnostic measures [ 18 ]. In contrast, EMS transport may increase vigilance upon in-hospital treatment and thus accelerate treatment.…”

Accuracy of Perceived Estimated Travel Time by EMS to a Trauma Center in San Bernardino County, California

“…Previous investigations have shown that timely trauma system activation improves the trauma team performance as measured by time to chest radiograph. 16 However, it has further been determined that proactive trauma team activation and subsequent early trauma team arrival and mobilization of resources has no effect on ED length of stay and mortality in most patients. 16 , 17 Yet despite no noted increase in ED length of stay, early trauma team activation may be important in select cases such as when multiple trauma patients arrive simultaneously or for stroke and myocardial infarction cases when door-to-needle time could potentially be shortened.…”

“…Previous studies alluded to the fact that manually recorded data are subject to the human propensity to smoothen data. 16 , 27 For future studies, it may be beneficial for the trauma registry to move toward automatic capturing of time data.…”

Improving out‐of‐hospital notification in traumatic cardiac arrests with novel usage of smartphone application

“…Time is a key predictor of clinical outcomes in the critically injured patient. Timely out‐of‐hospital notifications from emergency medical services (EMS) transporting trauma patients are associated with decreased mortality, more rapid interventions in the emergency department (ED), and a shortened hospital length of stay 1‐3 . The importance of time is magnified in traumatic cardiac arrest, where the duration of out‐of‐hospital resuscitation predicts survival and is a critical factor in selecting appropriate patients for resuscitative procedures 4‐6 .…”