[Emergency room activation due to trauma mechanism]

Area of Science:

• Trauma Care
• Emergency Medicine
• Surgical Critical Care

Background:

• German trauma care quality enhanced by white paper standards and S3 guidelines.
• Trauma resuscitation unit (TRU) management is critical for multiple trauma patients, requiring significant resources.
• Research has focused on TRU indications and hospital selection since structured trauma care began.

Purpose of the Study:

• To analyze emergency room (ER) assignments in a Level I trauma center.
• To compare patients admitted based on accident mechanism (GoR B) versus injury severity (GoR A).
• To evaluate the severity and resource needs of patients admitted via GoR B criteria.

Main Methods:

• Retrospective analysis of 686 ER trauma cases at a Level I trauma center.
• Comparison of 235 patients assigned by GoR B criteria with 104 patients assigned by GoR A criteria.
• Data collected included demographics, injury region, Injury Severity Score (ISS), ICU/hospital length of stay, and need for surgery/transfusion.

Main Results:

• 34% of ER trauma allocations were due to accident mechanism (GoR B).
• GoR B patients had an average ISS of 11, nearly half that of GoR A patients.
• 74% of GoR B patients required ICU admission (average 3 days), with 4-18% having severe injuries (AIS 3) and 17.9% classified as polytrauma (ISS ≥ 16).

Conclusions:

• A significant proportion of patients admitted via GoR B criteria present with severe, potentially life-threatening injuries.
• These patients require prioritized and immediate treatment by a dedicated trauma resuscitation unit team.
• The adequacy of a reduced TCU team for GoR B patients warrants critical evaluation.