Trauma Team Activation at an Emergency Department

Aim: Multidisciplinary trauma teams are routinely activated for patients with serious injuries in the emergency department (ED). We aim to describe the characteristics of patients requiring trauma team activation (TTA) at a level two trauma centre. Materials and Methods: A retrospective review of a single centre’s trauma registry data was performed. Information on demographics, circumstances of trauma, details of injury, and clinical progress was collected and analysed. Results: Among 77,132 trauma cases, 496 (0.6%) required TTA. On average, one TTA occurred every three days. The median age was 38 years [interquartile range (IQR), 28-54 years], and 367 (74.0%) were male. The primary reason for TTA was the mechanism of injury (n=418, 84.3%). Blunt injuries occurred in 453 (91.3%) patients and vehicular accidents were the most common mechanism (n=342, 69.0%). The median injury severity score was 1 (IQR: 0-9). Twenty patients (4.0%) required emergency surgery. The overall mortality was 60 (12.1%), with 49 patients (9.9%) dying in the ED. Four hundred and one patients (80.8%) were admitted to the hospital; the median length of stay was 2 days (IQR 1-5 days). Conclusion: TTA was an uncommon event; when it occurred, patients generally had low injury severity and low utilisation of healthcare resources. Revision of the activation criteria and a tiered trauma-team or expedited-care approach may help achieve a balance between timely, coordinated care and the justified, optimal deployment of personnel.