Intubated Trauma Patients Do Not Require Full Trauma Team Activation when Effectively Triaged.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Full trauma team activation (Level 1) is resource-intensive and reserved for critically injured patients.
• Overtriage leads to inefficient resource allocation.
• The use of intubation alone as a criterion for Level 1 trauma activation is debated.

Purpose of the Study:

• To evaluate if intubation alone warrants the highest level of trauma activation.
• To assess the outcomes of intubated trauma patients based on their activation level.

Main Methods:

• Retrospective review of trauma patients from 2012-2013.
• Analysis of activation levels, injury characteristics, intubation status, and patient outcomes.
• Comparison of intubated Level 1 and Level 2 trauma patients.

Main Results:

• Of 5,881 patients, 11% were Level 1 and 48% were Level 2 activations.
• Intubated Level 2 patients had higher systolic blood pressure, lower Injury Severity Score, and lower mortality than intubated Level 1 patients.
• Fewer intubated Level 2 patients underwent laparotomy, and deaths were primarily due to brain injuries.

Conclusions:

• Selected intubated trauma patients can receive timely and efficient care without requiring full trauma activation.
• Appropriate triage is crucial for optimizing resource utilization in trauma care.