Christian Waydhas1,2, Markus Baake3, Lars Becker4, Boris Buck5, Helena Düsing6, Björn Heindl7, Kai Oliver Jensen8, Rolf Lefering9, Carsten Mand10, T Paffrath11, Uwe Schweigkofler12, Kai Sprengel8, Heiko Trentzsch13, Bernd Wohlrath14, Dan Bieler15. 1. Klinik und Poliklinik für Chirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany. christian.waydhas@bergmannsheil.de. 2. Medizinische Fakultät, Universität Duisburg-Essen, Essen, Germany. christian.waydhas@bergmannsheil.de. 3. Unfall- und Wiederherstellungschirurgie, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292, Trier, Germany. 4. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Germany. 5. Klinikum der Universität München, Campus Großhadern, Zentrale Notaufnahme, Marchioninistraße 15, 81377, Munich, Germany. 6. Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149, Münster, Germany. 7. Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Städt. Klinikum Solingen, Gotenstr. 1, 42653, Solingen, Germany. 8. Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091, Zurich, Switzerland. 9. Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany. 10. Standort Marburg, Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Baldingerstr., 35043, Marburg, Germany. 11. Klinik für Unfallchirurgie, Orthopädie & Sporttraumatologie, Kliniken der Stadt Köln, Klinikum der Privaten, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany. 12. Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany. 13. Institut für Notfallmedizin und Medizinmanagement - INM, Klinikum der Universität München, Schillerstr. 53, 80336, Munich, Germany. 14. Abteilung für Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany. 15. Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Strasse 170, 56072, Koblenz, Germany.
Abstract
BACKGROUND: Trauma team activation (TTA) represents a considerable expenditure of trauma centre resources. It is mainly triggered by field triage criteria. The overall quality of the criteria may be evaluated based on the rate of over- and undertriage. However, there is no gold standard that defines which adult patients truly require a trauma team. The objective of this study was to develop consensus-based criteria defining the necessity for a trauma team. METHODS: A consensus group was formed by trauma specialists experienced in emergency and trauma care with a specific interest in field triage and having previously participated in guideline development. A literature search was conducted to identify criteria that have already been used or suggested. The initial list of criteria was discussed in two Delphi round and two consensus conferences. The entire process of discussion and voting was highly standardized and extensively documented, resulting in a final list of criteria. RESULTS: Initially 95 criteria were identified. This was subsequently reduced to 20 final criteria to appropriately indicate the requirement for attendance of a trauma team. The criteria address aspects related to injury severity, admission to an intensive care unit, death within 24 h, need for specified invasive procedures, need for surgical and/or interventional radiological procedures, and abnormal vital signs within a defined time period. CONCLUSIONS: The selected criteria may be applied as a tool for research and quality control concerning TTA. However, future studies are necessary to further evaluate for possible redundancy in criteria that may allow for further reduction in criteria.
BACKGROUND:Trauma team activation (TTA) represents a considerable expenditure of trauma centre resources. It is mainly triggered by field triage criteria. The overall quality of the criteria may be evaluated based on the rate of over- and undertriage. However, there is no gold standard that defines which adult patients truly require a trauma team. The objective of this study was to develop consensus-based criteria defining the necessity for a trauma team. METHODS: A consensus group was formed by trauma specialists experienced in emergency and trauma care with a specific interest in field triage and having previously participated in guideline development. A literature search was conducted to identify criteria that have already been used or suggested. The initial list of criteria was discussed in two Delphi round and two consensus conferences. The entire process of discussion and voting was highly standardized and extensively documented, resulting in a final list of criteria. RESULTS: Initially 95 criteria were identified. This was subsequently reduced to 20 final criteria to appropriately indicate the requirement for attendance of a trauma team. The criteria address aspects related to injury severity, admission to an intensive care unit, death within 24 h, need for specified invasive procedures, need for surgical and/or interventional radiological procedures, and abnormal vital signs within a defined time period. CONCLUSIONS: The selected criteria may be applied as a tool for research and quality control concerning TTA. However, future studies are necessary to further evaluate for possible redundancy in criteria that may allow for further reduction in criteria.
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