Outcomes of patients using a tiered trauma response protocol

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Healthcare Systems Analysis

Background:

• Trauma centers utilize trauma team activations to manage critically injured patients.
• Evaluating the impact of different activation protocols on patient care and outcomes is crucial for optimizing trauma system performance.

Purpose of the Study:

• To compare patient care processes and outcomes between full trauma team activation (FULL) and modified trauma team activation (MOD) at a Level I trauma center.
• To assess the effectiveness of a newly implemented two-tiered trauma response protocol.

Main Methods:

• Retrospective analysis of patients within a regional trauma system over two distinct 2-year periods.
• Comparison of exclusively FULL activations versus a subsequent period with both FULL and MOD activations.
• Case-control analysis of undertriaged MOD patients against FULL criteria.

Main Results:

• The two-tiered system resulted in 55% MOD and 45% FULL activations.
• Post-implementation patients experienced longer emergency department times, but mortality rates remained similar.
• Undertriaged MOD patients who met FULL criteria had a low mortality rate.

Conclusions:

• The tiered trauma activation protocol significantly altered emergency department operations and improved efficiency.
• No adverse patient outcomes were identified despite nominal increases in process times.
• Further refinement is needed to enhance the accuracy of categorizing patients into MOD or FULL trauma activations.