[Organisation of trauma services--major improvements over four years]

Despite recent developments in trauma care, it is estimated that 10 to 15% of deaths after injury are avoidable and caused by errors in the initial hospital phase of treatment. In 2000 it was found that a number of Norwegian hospitals lacked procedures and protocols. The situation in all hospitals delivering trauma care in Norway was reassessed.

In autumn of 2004, all 50 Norwegian trauma care hospitals were surveyed. Response was obtained from all.

Trauma teams were found in 88% of all hospitals, compared to 52% in 2000. A parallel improvement was found in the use of paging criteria for trauma teams, use of trauma manuals and protocols, and designated patient charts. Targeted training of teams was done in 88% of the hospitals and 54 % had arranged practical drills of trauma teams in the six months prior to the survey. Only minor differences were found between hospitals at different levels. Systematic audits were performed in only 27% of hospitals.

A major improvement has taken place during four years, and it is now possible to implement national trauma care guidelines. There is still a need for improved use of audits and team training.