Correspondence (letter to the editor): Team Leadership in the Emergency Room

We thank Neugebauer et al for their summary of the S3 guideline on the treatment of patients with severe and multiple traumatic injuries (1).

Discussions that have already reached a conclusion, on the subject of who has the legitimation to lead treatment in the emergency room, should not again have been presented in a one-sided way in the summarized guideline (p. 105 of the article). The options for team leadership in the emergency room were subject to intense multidisciplinary discussion in the context of the guideline process and were formulated unequivocally in the text of the guideline. No robust evidence was identified in support of the superiority of a particular leadership structure in the emergency setting (“trauma lead” vs “multidisciplinary teamwork without a team leader”) or of a “trauma lead” belonging to a particular medical specialty (anesthesiology, surgery, trauma surgery) with regard to patients’ survival (2, 3). The guideline therefore stipulates: “team leadership is required, regardless of which medical specialty is represented or whether an individual or a team takes over (3). Within the institution, the functions and qualifications of the team leader or multidisciplinary leadership team in the emergency room should be defined. Ideally, after discussion, the “best individual” or “best persons” should take over the task of the trauma lead or multidisciplinary leadership team” (2). In our opinion, these additional comments are essential for the appropriate and unequivocal application of the S3 guideline for patients with severe and multiple traumatic injuries and for high-quality multidisciplinary patient care in the emergency room.