Original Article

You have full text access to this OnlineOpen article

Efficacy of a two-tiered trauma team activation protocol in a Norwegian trauma centre

  1. M. Rehn1,2,*,
  2. H. M. Lossius1,3,
  3. K. E. Tjosevik4,
  4. M. Vetrhus5,
  5. O. Østebø4,
  6. T. Eken6,
  7. and the Rogaland Trauma System Study Collaborating Group†

Article first published online: 20 DEC 2011

DOI: 10.1002/bjs.7794

Issue

British Journal of Surgery

British Journal of Surgery

Volume 99, Issue 2, pages 199–208, February 2012

Additional Information

How to Cite

Rehn, M., Lossius, H. M., Tjosevik, K. E., Vetrhus, M., Østebø, O., Eken, T. and and the Rogaland Trauma System Study Collaborating Group (2012), Efficacy of a two-tiered trauma team activation protocol in a Norwegian trauma centre. Br J Surg, 99: 199–208. doi: 10.1002/bjs.7794

Author Information

  1. 1

    Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway

  2. 2

    Akershus University Hospital, Lørenskog, Norway

  3. 3

    Department of Surgical Sciences, University of Bergen, Bergen, Norway

  4. 4

    Acute Clinic, Stavanger University Hospital, Stavanger, Norway

  5. 5

    Department of Surgery, Stavanger University Hospital, Stavanger, Norway

  6. 6

    Department of Anaesthesiology, Oslo University Hospital Ullevål, Oslo, Norway

  1. †

    Members of the Rogaland Trauma System Study Collaborating Group can be found under the heading Collaborators

*Norwegian Air Ambulance Foundation, PO Box 94, 1441 Drøbak, Norway

Publication History

  1. Issue published online: 6 JAN 2012
  2. Article first published online: 20 DEC 2011
  3. Manuscript Accepted: 5 OCT 2011

Funded by

  • Re-use of this article is permitted in accordance with the Terms and Conditions set out at [http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms]

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (189K)

References

  • 1
    Sasser SM, Hunt RC, Sullivent EE, Wald MM, Mitchko J, Jurkovich GJ et al. National Expert Panel on Field Triage CfDC, Prevention. Guidelines for field triage of injured patients. Recommendations of the National Expert Panel on Field Triage. MMWR Recomm Rep 2009; 58(RR-1): 1–35.
  • 2
    Lerner EB. Studies evaluating current field triage: 1966–2005. Prehosp Emerg Care 2006; 10: 303–306.
  • 3
    Isaksen MI, Wisborg T, Brattebo G. Organisation of trauma services—major improvements over four years. Tidsskr Nor Laegeforen 2006; 126: 145–147.
  • 4
    Petrie D, Lane P, Stewart TC. An evaluation of patient outcomes comparing trauma team activated versus trauma team not activated using TRISS analysis. Trauma and Injury Severity Score. J Trauma 1996; 41: 870–873.
  • 5
    Rehn M, Eken T, Krüger AJ, Steen PA, Skaga NO, Lossius HM. Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelines. Scand J Trauma Resusc Emerg Med 2009; 17: 1.
  • 6
    Uleberg O, Vinjevoll OP, Eriksson U, Aadahl P, Skogvoll E. Overtriage in trauma—what are the causes? Acta Anaesthesiol Scand 2007; 51: 1178–1183.
  • 7
    Kann SH, Hougaard K, Christensen EF. Evaluation of pre-hospital trauma triage criteria: a prospective study at a Danish level I trauma centre. Acta Anaesthesiol Scand 2007; 51: 1172–1177.
  • 8
    Dehli T, Fredriksen K, Osbakk SA, Bartnes K. Evaluation of a university hospital trauma team activation protocol. Scand J Trauma Resusc Emerg Med 2011; 19: 18.
  • 9
    Sasser S, Varghese M, Kellermann A, Lormand J. Prehospital Trauma Care Systems. World Health Organization: Geneva, 2005.
  • 10
    Davis T, Dinh M, Roncal S, Byrne C, Petchell J, Leonard E et al. Prospective evaluation of a two-tiered trauma activation protocol in an Australian major trauma referral hospital. Injury 2010; 41: 470–474.
  • 11
    Kouzminova N, Shatney C, Palm E, McCullough M, Sherck J. The efficacy of a two-tiered trauma activation system at a level I trauma center. J Trauma 2009; 67: 829–833.
  • 12
    Lehmann R, Brounts L, Lesperance K, Eckert M, Casey L, Beekley A et al. A simplified set of trauma triage criteria to safely reduce overtriage: a prospective study. Arch Surg 2009; 144: 853–858.
  • 13
    Chen LE, Snyder AK, Minkes RK, Dillon PA, Foglia RP. Trauma stat and trauma minor: are we making the call appropriately? Pediatr Emerg Care 2004; 20: 421–425.
  • 14
    Eastes LS, Norton R, Brand D, Pearson S, Mullins RJ. Outcomes of patients using a tiered trauma response protocol. J Trauma 2001; 50: 908–913.
  • 15
    Ryan JM, Gaudry PL, McDougall PA, McGrath PJ. Implementation of a two-tier trauma response. Injury 1998; 29: 677–683.
  • 16
    Plaisier BR, Meldon SW, Super DM, Jouriles NJ, Barnoski AL, Fallon WF Jr et al. Effectiveness of a 2-specialty, 2-tiered triage and trauma team activation protocol. Ann Emerg Med 1998; 32: 436–441.
  • 17
    Terregino CA, Reid JC, Marburger RK, Leipold CG, Ross SE. Secondary emergency department triage (supertriage) and trauma team activation: effects on resource utilization and patient care. J Trauma 1997; 43: 61–64.
  • 18
    Tinkoff GH, O'Connor RE, Fulda GJ. Impact of a two-tiered trauma response in the emergency department: promoting efficient resource utilization. J Trauma 1996; 41: 735–740.
  • 19
    Ochsner MG, Schmidt JA, Rozycki GS, Champion HR. The evaluation of a two-tier trauma response system at a major trauma center: is it cost effective and safe? J Trauma 1995; 39: 971–977.
  • 20
    DeKeyser FG, Paratore A, Seneca RP, Trask A. Decreasing the cost of trauma care: a system of secondary inhospital triage. Ann Emerg Med 1994; 23: 841–844.
  • 21
    Simon B, Gabor R, Letourneau P. Secondary triage of the injured pediatric patient within the trauma center: support for a selective resource-sparing two-stage system. Pediatr Emerg Care 2004; 20: 5–11.
  • 22
    ACS-COT. Resources for Optimal Care of the Injured Patient: 2006. American College of Surgeons: Chicago, 2006.
  • 23
    Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma 1997; 43: 922–925.
  • 24
    Heskestad B, Baardsen R, Helseth E, Romner B, Waterloo K, Ingebrigtsen T. Incidence of hospital referred head injuries in Norway: a population based survey from the Stavanger region. Scand J Trauma Resusc Emerg Med 2009; 17: 6.
  • 25
    Meling T, Harboe K, Soreide K. Incidence of traumatic long-bone fractures requiring in-hospital management: a prospective age- and gender-specific analysis of 4890 fractures. Injury 2009; 40: 1212–1219.
  • 26
    Nakstad AR, Sørebø H, Heimdal HJ, Strand T, Sandberg M. Rapid response car as a supplement to the helicopter in a physician-based HEMS system. Acta Anaesthesiol Scand 2004; 48: 588–591.
    Direct Link:
  • 27
    Association for the Advancement of Automotive Medicine (AAAM). The Abbreviated Injury Scale 1990 revision—Update 98. AAAM: Des Plains, 1998.
  • 28
    Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Røise O et al. The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med 2008; 16: 7.
  • 29
    Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney S. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Qual Saf Health Care 2008; 17(Suppl 1): i3–i9.
  • 30
    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM et al. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 2003; 138: W1–W12.
  • 31
    von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ 2007; 85: 867–872.
  • 32
    Eastman A, Lewis FJ, Champion H, Mattox K. Regional trauma system design: critical concepts. Am J Surg 1987; 154: 79–87.
  • 33
    Lossius HM, Langhelle A, Pillgram-Larsen J, Lossius TA, Soreide E, Laake P et al. Efficiency of activation of the trauma team in a Norwegian trauma referral centre. Eur J Surg 2000; 166: 760–764.
    Direct Link:
  • 34
    Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma 1987; 27: 370–378.
  • 35
    Champion HR, Sacco WJ, Copes WS. Injury severity scoring again. J Trauma 1995; 38: 94–95.
  • 36
    Flora JD Jr. A method for comparing survival of burn patients to a standard survival curve. J Trauma 1978; 18: 701–705.
  • 37
    Norum J, Elsbak TM. The ambulance services in northern Norway 2004–2008: improved competence, more tasks, better logistics and increased costs. Int J Emerg Med 2010; 3: 69–74.
  • 38
    Velmahos GC, Jindal A, Chan LS, Murray JA, Vassiliu P, Berne TV et al. ‘Insignificant’ mechanism of injury: not to be taken lightly. J Am Coll Surg 2001; 192: 147–152.
  • 39
    Demetriades D, Sava J, Alo K, Newton E, Velmahos G, Murray J et al. Old age as a criterion for trauma team activation. J Trauma 2001; 51: 754–756.
  • 40
    Fishman PE, Shofer FS, Robey JL, Zogby KE, Reilly PM, Branas CC et al. The impact of trauma activations on the care of emergency department patients with potential acute coronary syndromes. Ann Emerg Med 2006; 48: 347–353.
  • 41
    Brown JB, Stassen NA, Bankey PE, Sangosanya AT, Cheng JD, Gestring ML. Mechanism of injury and special consideration criteria still matter: an evaluation of the National Trauma Triage Protocol. J Trauma 2011; 70: 38–44.
  • 42
    Franke R, Kaul J. The Hawthorne experiments: first statistical interpretation. Am Sociol Rev 1978; 43: 623–643.
  • 43
    Rehn M, Perel P, Blackhall K, Lossius HM. Prognostic models for the early care of trauma patients: a systematic review. Scand J Trauma Resusc Emerg Med 2011; 19: 17.
  • 44
    Curtis K, Olivier J, Mitchell R, Cook A, Rankin T, Rana A et al. Evaluation of a tiered trauma call system in a level 1 trauma centre. Injury 2011; 42: 57–62.
  • 45
    Straus SE, Tetroe J, Graham I. Defining knowledge translation. CMAJ 2009; 181: 165.
View Full Article (HTML) Get PDF (189K)