Table 3.

District-level hospital trauma care audit filters with panelist consensus using the Delphi technique.

Target process	Proposed audit filter
Triage	1.Vital signs are recorded within 15 minutes of arrival (must include breathing assessment, heart rate, blood pressure, oxygen saturation if available). 2.If difficulty breathing, OR shock present at triage (HR >100, OR SBP <110)* OR oxygen saturation ≤95%, a senior provider (e.g. in-charge, medical officer) is made aware of the patient immediately.
Airway	1.The clinician asked the patient a question and listened for a response to assess airway patency. 2.Patient with difficulty or obstructed breathing received basic airway maneuver assistance (i.e. sweep, chin-lift-jaw-thrust, oral or nasal airway, suction).
Breathing	1.Examination for pneumo- or haemo-thorax was done within 15 minutes of patient arrival by listening to both sides of the chest with a stethoscope AND bilateral percussion. 2.If pneumo- or haemo-thorax is suspected OR confirmed AND oxygen saturation was less than 98%, a chest tube was placed within 30 minutes of patient arrival.
Circulation	1.A large bore IV was placed within 15 minutes of patient arrival. 2.If there is external bleeding at patient arrival, pressure is applied and maintained until definitive control is performed.
Disability	1.If AVPU is not ‘A’ AND the patient is not in shock, the head of the bed is elevated to 45 degrees. 2.Long bone fracture is reduced with analgesia and/or splinted within 2 hours of admission or prior to transfer.
Exposure	1.Patient is completely undressed, fully examined and covered for privacy within 30 minutes of arrival. 2.The fluid order for a burn patient using the Parkland formula is recorded within 1 hour for burns over 15% total body surface area that occurred less than 24 hours from patient arrival.
Outcome	• Date and time and hospital discharge, referral or death.

HR – heart rate; SBP – systolic blood pressure

^*pediatric-specific vital signs representing shock should be available to practitioners and be applied when appropriate; IV – intravenous catheter; AVPU – a validated clinical neurological assessment endorsed by the World Health Organization: A is alert, V is responds to voice, P is responds to pain, and U is unresponsive. Proposed audit filters target essential trauma care processes for non-ambulatory patients and those triaged yellow, orange or red using the South African Triage Scale.[30]