Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre : which patients are missing out?
© 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons..
BACKGROUND: Trauma team activation (TTA) is paramount in the early hospital management of trauma patients. This study aimed to evaluate factors which contribute to failure to activate the Trauma team for management of paediatric trauma.
METHODS: A retrospective cohort study of Emergency Department (ED) presentations at the paediatric major trauma hospital in Adelaide, South Australia was conducted over a 16-month period. Data from the hospital's trauma registry, individual case files and digital medical records were evaluated to determine factors that were associated with no TTA.
RESULTS: During the study period, 617 trauma patients who met Level 1 or Level 2 TTA criteria attended the trauma centre. For 29 (4.7%) of these patients, there was no TTA. Predictors of no TTA included sustaining abdomen and/or pelvis injuries compared to limb injuries (unadjusted odds ratio [OR] = 10.59, 95% confidence interval [CI] 1.98-56.69, P = 0.006), sustaining non-accidental injury (NAI) versus an injury with vehicle involvement (OR = 30.13, 95% CI 6.43-141.21, P < 0.001), and arriving via emergency medical retrieval service compared to private vehicle (OR = 14.23, 95% CI 3.94-51.36, P < 0.001). No patients transferred directly to Paediatric Intensive Care Unit (PICU), or High Dependency Unit (HDU) received an appropriate TTA.
CONCLUSION: Multiple factors were associated with no TTA in paediatric trauma patients. The results highlight that even in PICU and HDU admissions and transfer patients, vigilant clarification of mechanism of injury and potential for occult injuries should be undertaken to ensure appropriate TTA and improve patient outcome.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:92 |
|---|---|
| Enthalten in: |
ANZ journal of surgery - 92(2022), 10 vom: 15. Okt., Seite 2628-2634 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Sung, Jonghoo [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Emergency medical services |
|---|
| Anmerkungen: |
Date Completed 13.10.2022 Date Revised 29.12.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/ans.17906 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM343538334 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM343538334 | ||
| 003 | DE-627 | ||
| 005 | 20231226020702.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/ans.17906 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1145.xml |
| 035 | |a (DE-627)NLM343538334 | ||
| 035 | |a (NLM)35833510 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Sung, Jonghoo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre |b which patients are missing out? |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 13.10.2022 | ||
| 500 | |a Date Revised 29.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. | ||
| 520 | |a BACKGROUND: Trauma team activation (TTA) is paramount in the early hospital management of trauma patients. This study aimed to evaluate factors which contribute to failure to activate the Trauma team for management of paediatric trauma | ||
| 520 | |a METHODS: A retrospective cohort study of Emergency Department (ED) presentations at the paediatric major trauma hospital in Adelaide, South Australia was conducted over a 16-month period. Data from the hospital's trauma registry, individual case files and digital medical records were evaluated to determine factors that were associated with no TTA | ||
| 520 | |a RESULTS: During the study period, 617 trauma patients who met Level 1 or Level 2 TTA criteria attended the trauma centre. For 29 (4.7%) of these patients, there was no TTA. Predictors of no TTA included sustaining abdomen and/or pelvis injuries compared to limb injuries (unadjusted odds ratio [OR] = 10.59, 95% confidence interval [CI] 1.98-56.69, P = 0.006), sustaining non-accidental injury (NAI) versus an injury with vehicle involvement (OR = 30.13, 95% CI 6.43-141.21, P < 0.001), and arriving via emergency medical retrieval service compared to private vehicle (OR = 14.23, 95% CI 3.94-51.36, P < 0.001). No patients transferred directly to Paediatric Intensive Care Unit (PICU), or High Dependency Unit (HDU) received an appropriate TTA | ||
| 520 | |a CONCLUSION: Multiple factors were associated with no TTA in paediatric trauma patients. The results highlight that even in PICU and HDU admissions and transfer patients, vigilant clarification of mechanism of injury and potential for occult injuries should be undertaken to ensure appropriate TTA and improve patient outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a emergency medical services | |
| 650 | 4 | |a orthopaedic surgery | |
| 650 | 4 | |a paediatric hospitals | |
| 650 | 4 | |a paediatric surgery | |
| 650 | 4 | |a trauma | |
| 650 | 4 | |a trauma centres | |
| 650 | 4 | |a triage | |
| 700 | 1 | |a Yao, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Antoniou, Georgia |e verfasserin |4 aut | |
| 700 | 1 | |a Cooksey, Rebecca |e verfasserin |4 aut | |
| 700 | 1 | |a Winters, Jacqueline |e verfasserin |4 aut | |
| 700 | 1 | |a Ee, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Williams, Nicole |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t ANZ journal of surgery |d 2001 |g 92(2022), 10 vom: 15. Okt., Seite 2628-2634 |w (DE-627)NLM110804864 |x 1445-2197 |7 nnns |
| 773 | 1 | 8 | |g volume:92 |g year:2022 |g number:10 |g day:15 |g month:10 |g pages:2628-2634 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/ans.17906 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 92 |j 2022 |e 10 |b 15 |c 10 |h 2628-2634 | ||