Why do our hospitals not make more use of the concept of a trauma team?

Ferguson, David; Edbrooke, D. L.; Wardrope, J; Crosby, A C

doi:10.1136/bmj.290.6465.392

Cited by 2 publications

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“…Surgical staff are nevertheless notified and attend as soon as possible. What is clear we believe, is that there is no place for junior doctors to be left to manage trauma patients unsupervised, and that consultant staff should always be involved from an early stage to guide treatment and disposal decisions 10,11,16,19,30,40,41,44–52 .…”

Section: Trauma Team Structurementioning

confidence: 99%

Trauma teams: order from chaos

et al. 1993

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Introduction: Trauma systems based on trauma centres have become the gold standard for trauma care in North America. The epidemiology of trauma in the United Kingdom and Australasia is significantly different. The standard of care of patients with blunt injuries in British hospitals may not be as high as in North America. There is ongoing research into the best system of care. Until convincing results are available, adoption of a trauma team approach by all hospitals receiving major trauma would be appropriate. The purpose of this paper is to provide sufficient detail of an operational trauma team to allow others to develop a similar system. Methods: We introduced a trauma team approach in the Emergency Department of the Royal Brisbane Hospital, a tertiary referral teaching hospital. Laminated action cards detailed precise task allocation to four doctor‐nurse pairs working simultaneously. Equipment, procedures, pathology requests, radiology and clerical duties were standardised in advance. An audit form was completed after each resuscitation. Results: In an initial review, 108 patients admitted with trauma met criteria for activation of the trauma team. Time of arrival to completion of initial resuscitation was reduced by 63 per cent and time in the department by 51 per cent. Conclusion: A major component of the success of the best American trauma systems lies in organisation. By contrast, many hospitals in the United Kingdom and Australasia still have no organised response to trauma and where trauma teams do exist, they are often ad hoc and disorganised. The absence of a defined team leader and precise task allocation leads to confusion and delay even when individual team members are highly skilled. We describe a trauma team approach to overcome these problems which could be utilised by any hospital using existing staff and resources.

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Section: Trauma Team Structurementioning

confidence: 99%

Trauma teams: order from chaos

et al. 1993

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A Prospective Study of the Performance of the Trauma Team Leader

Sugrue

Seger

Kerridge

et al. 1995

The Journal of Trauma: Injury, Infection, and Critical Care

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This study assessed the performance of the trauma team leader in 50 consecutive trauma resuscitations at Liverpool Hospital over a two-month period. The trauma team consists of intensive care (ICU), emergency, and surgical registrars, three nurses, a wardsman, a radiographer, and a social worker. The team leader position alternates between the ICU and emergency registrar on a fortnightly roster. A panel of specialists experienced in trauma management evaluated 38 aspects of the initial resuscitation. Individual variables received different weightings. The maximum possible score for team leader performance was 80. The mean team leader score was 70.4 +/- 8 (SD). The main deficiencies in the team leader's performances were in their interpersonal communications and in the adequacy of documentation of the history of the injury. In 20% of resuscitations there were failures to completely expose the patient. Medical skills were uniformly well performed. Poor communication with other team members were the main pitfall of the team leader in this study. The team leader score may prove a useful tool in improving the quality of the trauma team.

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Why do our hospitals not make more use of the concept of a trauma team?

Cited by 2 publications

References 1 publication

Trauma teams: order from chaos

Trauma teams: order from chaos

A Prospective Study of the Performance of the Trauma Team Leader

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