A Consensus-Based Criterion Standard for the Requirement of a Trauma Team
Corresponding Author
Christian Waydhas
- [email protected]
- [email protected]
- +49 234 3023821
Klinik und Poliklinik für Chirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Medizinische Fakultät, Universität Duisburg-Essen, Essen, Germany
Tel.: +49 234 3023821, [email protected], [email protected]Search for more papers by this authorMarkus Baake
Unfall- und Wiederherstellungschirurgie, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292 Trier, Germany
Search for more papers by this authorLars Becker
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147 Essen, Germany
Search for more papers by this authorBoris Buck
Klinikum der Universität München, Campus Großhadern, Zentrale Notaufnahme, Marchioninistraße 15, 81377 Munich, Germany
Search for more papers by this authorHelena Düsing
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149 Münster, Germany
Search for more papers by this authorBjörn Heindl
Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Städt. Klinikum Solingen, Gotenstr. 1, 42653 Solingen, Germany
Search for more papers by this authorKai Oliver Jensen
Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
Search for more papers by this authorRolf Lefering
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109 Cologne, Germany
Search for more papers by this authorCarsten Mand
Standort Marburg, Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Baldingerstr., 35043 Marburg, Germany
Search for more papers by this authorT. Paffrath
Klinik für Unfallchirurgie, Orthopädie & Sporttraumatologie, Kliniken der Stadt Köln, Klinikum der Privaten, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109 Cologne, Germany
Search for more papers by this authorUwe Schweigkofler
Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstrasse 430, 60389 Frankfurt am Main, Germany
Search for more papers by this authorKai Sprengel
Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
Search for more papers by this authorHeiko Trentzsch
Institut für Notfallmedizin und Medizinmanagement – INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany
Search for more papers by this authorBernd Wohlrath
Abteilung für Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389 Frankfurt am Main, Germany
Search for more papers by this authorDan Bieler
Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Strasse 170, 56072 Koblenz, Germany
Search for more papers by this authorCorresponding Author
Christian Waydhas
- [email protected]
- [email protected]
- +49 234 3023821
Klinik und Poliklinik für Chirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
Medizinische Fakultät, Universität Duisburg-Essen, Essen, Germany
Tel.: +49 234 3023821, [email protected], [email protected]Search for more papers by this authorMarkus Baake
Unfall- und Wiederherstellungschirurgie, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292 Trier, Germany
Search for more papers by this authorLars Becker
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45147 Essen, Germany
Search for more papers by this authorBoris Buck
Klinikum der Universität München, Campus Großhadern, Zentrale Notaufnahme, Marchioninistraße 15, 81377 Munich, Germany
Search for more papers by this authorHelena Düsing
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149 Münster, Germany
Search for more papers by this authorBjörn Heindl
Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Städt. Klinikum Solingen, Gotenstr. 1, 42653 Solingen, Germany
Search for more papers by this authorKai Oliver Jensen
Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
Search for more papers by this authorRolf Lefering
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Strasse 200, 51109 Cologne, Germany
Search for more papers by this authorCarsten Mand
Standort Marburg, Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Baldingerstr., 35043 Marburg, Germany
Search for more papers by this authorT. Paffrath
Klinik für Unfallchirurgie, Orthopädie & Sporttraumatologie, Kliniken der Stadt Köln, Klinikum der Privaten, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109 Cologne, Germany
Search for more papers by this authorUwe Schweigkofler
Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstrasse 430, 60389 Frankfurt am Main, Germany
Search for more papers by this authorKai Sprengel
Klinik für Traumatologie, UniversitätsSpital Zürich, Rämistrasse 100, 8091 Zurich, Switzerland
Search for more papers by this authorHeiko Trentzsch
Institut für Notfallmedizin und Medizinmanagement – INM, Klinikum der Universität München, Schillerstr. 53, 80336 Munich, Germany
Search for more papers by this authorBernd Wohlrath
Abteilung für Unfallchirurgie und Orthopädische Chirurgie, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389 Frankfurt am Main, Germany
Search for more papers by this authorDan Bieler
Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, Verbrennungsmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Strasse 170, 56072 Koblenz, Germany
Search for more papers by this authorAbstract
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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