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World Journal of Surgery

, Volume 42, Issue 9, pp 2800–2809 | Cite as

A Consensus-Based Criterion Standard for the Requirement of a Trauma Team

  • Christian Waydhas
  • Markus Baake
  • Lars Becker
  • Boris Buck
  • Helena Düsing
  • Björn Heindl
  • Kai Oliver Jensen
  • Rolf Lefering
  • Carsten Mand
  • T. Paffrath
  • Uwe Schweigkofler
  • Kai Sprengel
  • Heiko Trentzsch
  • Bernd Wohlrath
  • Dan Bieler
Original Scientific Report

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.

Abbreviations

e.o.

Expert opinion

AIS

Abbreviated injury scale

ISS

Injury severity score

NISS

New injury severity score

GSW

Gun shout wound

ICU

Intensive care unit

LOS

Length of stay

ER

Emergency room

CPR

Cardiopulmonary resuscitation

PCC

Prothrombin complex concentrate

BW

Body weight

CT

Computed tomography

GCS

Glasgow coma scale

BP

Blood pressure

Notes

Acknowledgements

Sincere thanks to Dr. Henrik Teuber for revision of the English manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Christian Waydhas
    • 1
    • 2
  • Markus Baake
    • 3
  • Lars Becker
    • 4
  • Boris Buck
    • 6
  • Helena Düsing
    • 7
  • Björn Heindl
    • 8
  • Kai Oliver Jensen
    • 9
  • Rolf Lefering
    • 10
  • Carsten Mand
    • 11
  • T. Paffrath
    • 12
  • Uwe Schweigkofler
    • 13
  • Kai Sprengel
    • 9
  • Heiko Trentzsch
    • 14
  • Bernd Wohlrath
    • 15
  • Dan Bieler
    • 5
  1. 1.Klinik und Poliklinik für ChirurgieBerufsgenossenschaftliches Universitätsklinikum Bergmannsheil BochumBochumGermany
  2. 2.Medizinische FakultätUniversität Duisburg-EssenEssenGermany
  3. 3.Unfall- und Wiederherstellungschirurgie, Krankenhaus der Barmherzigen BrüderTrierGermany
  4. 4.Klinik für Orthopädie und UnfallchirurgieUniversitätsklinikum EssenEssenGermany
  5. 5.Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, VerbrennungsmedizinBundeswehrzentralkrankenhaus KoblenzKoblenzGermany
  6. 6.Klinikum der Universität MünchenMunichGermany
  7. 7.Klinik und Poliklinik für Unfall-, Hand- und WiederherstellungschirurgieUniversitätsklinikum MünsterMünsterGermany
  8. 8.Klinik für Unfallchirurgie, Orthopädie und HandchirurgieStädt. Klinikum SolingenSolingenGermany
  9. 9.Klinik für TraumatologieUniversitätsSpital ZürichZurichSwitzerland
  10. 10.Institute for Research in Operative Medicine (IFOM)Witten/Herdecke UniversityCologneGermany
  11. 11.Standort Marburg, Zentrum für Orthopädie und UnfallchirurgieUniversitätsklinikum Gießen und Marburg GmbHMarburgGermany
  12. 12.Klinik für Unfallchirurgie, Orthopädie & Sporttraumatologie, Kliniken der Stadt Köln, Klinikum der PrivatenUniversität Witten/HerdeckeCologneGermany
  13. 13.Unfallchirurgie und Orthopädische ChirurgieBG Unfallklinik Frankfurt am Main gGmbHFrankfurt am MainGermany
  14. 14.Institut für Notfallmedizin und Medizinmanagement – INMKlinikum der Universität MünchenMunichGermany
  15. 15.Abteilung für Unfallchirurgie und Orthopädische ChirurgieBG Unfallklinik Frankfurt am Main gGmbHFrankfurt am MainGermany

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