[When should the trauma team be activated?].

BACKGROUND: On admission to hospital, severely injured patients should be received by a trauma team so that the prospects of early life-saving treatment are not precluded. Considerations about use of resources indicate that the team is not activated when the likelihood of serious injury is low. A recommendation with criteria for activation of the trauma team has been established at the University Hospital of North Norway. We have studied how the recommendations were followed and calculated over- and under-triage and to highlight the question of whether activation should rather be automatically implemented based on predefined criteria.
MATERIAL AND METHODS: We use descriptive statistics to analyse compliance with the recommendation as well as pre- and intra-hospital data for trauma patients who prior to admission were recognised as having fulfilled the criteria.
RESULTS: Of the 109 trauma victims who, according to the recommendation, from 1 June 2001 to 31 May 2002 should have been received by the trauma team, 59 were received by a surgeon alone. Given that all patients with an injury severity score of 16 or more should be received by a trauma team, under-utilisation of the team was 50%, whereas the proportion of excess calls was 58%. Elimination of under-utilisation among this group of patients would, by strict adherence to the criteria, have conferred a very modest increase in the proportion of superfluous calls to 61%.
INTERPRETATION: The trauma team should be activated automatically in accordance with predefined criteria.