Table 1.
An analysis of individual criteria applied for trauma team activation
| Criteria category | Criterion | Criterio n(/reason) applied to the patient (no. of patients) | Criterion applied to a severely injured patient (ISS > 15a), (no. of patients) | Criterion applied to a patient receiving an emergency procedure (no. of patients) |
|---|---|---|---|---|
| Vital parameters | 1. Airway obstruction, stridor | 4 | 2 | 3 |
| 2. Tachypnoe (adults, respiratory rate > 30) | 14 | 10 | 3 | |
| 3. Heart rate > 130 (adults) | 3 | 0 | 2 | |
| 4. Systolic BP <90 mmHg | 9 | 5 | 4 | |
| 5. Lowered level of consciousness (GCSb <13) | 87 | 33 | 28 | |
| Extent of injuries | 6. Flail chest | 2 | 1 | 0 |
| 7. Unstable fracture of the pelvis. Fracture in two or more long bones | 5 | 2 | 0 | |
| 8. Traumatic amputation or crush injury above wrist/ankle | 1 | 0 | 1 | |
| 9. Injury in two or more body regions (head/neck/chest/abdomen/pelvis/femur/back) | 61 | 9 | 8 | |
| 10. Paralysis | 10 | 8 | 1 | |
| 11. Penetrating injury of the head/neck/chest/abdomen/pelvis/groin/back | 5 | 0 | 3 | |
| 12. 2. or 3. degree burn injury > 15 % body surface (children > 10 %) | 5 | 2 | 3 | |
| 13. Burn injury with inhalation injury | 5 | 2 | 2 | |
| 14. Hypothermia (core temperature <32 °C) | 11 | 3 | 2 | |
| Mechanism of injury | 15. Ejected from vehicle | 6 | 4 | 0 |
| 16. Co-passenger dead | 5 | 2 | 0 | |
| 17. Trapped in wreck | 9 | 3 | 1 | |
| 18. Pedestrian or cyclist hit by motor vehicle | 15 | 2 | 2 | |
| 19. Fall from >5 m | 20 | 10 | 3 | |
| 20. Avalanche accident | 1 | 0 | 0 | |
| Unknown criteria | ETAc < 15 min | 8 | 0 | 0 |
| Trauma team leader requested TTAd | 5 | 0 | 0 | |
| Anesthesiologist in ambulance helicopter requested TTAd | 6 | 0 | 0 | |
| Unknown/undocumented reason for TTAd | 20 | 0 | 0 |
The table shows the number of times an individual criteria is applied for trauma team activation based on prehospital information in potentially severely injured patients primarily admitted at the University Hospital of North Norway Tromsø during 2013–14, n = 223. Transferred patients are not included in this analysis. The two last columns shows the number of times the individual criterion correctly activated the trauma team assessed with ISS and the appearance of an emergency procedure. More than one criterion can be applied to one patient
Emergency surgical procedure include endotracheal intubation, damage control thoracotomy, damage control laparotomy, extraperitoneal packing in the pelvis, revascularization of an extremity, intervention radiology, craniotomy, insertion of intracranial pressure bolt, chest tube insertion, external fracture stabilization or other emergency procedures aiming at stabilizing airway, respiration or circulation
ISSa: Injury Severity Score, ISS > 15: Severely injured patient, GCSb: Glasgow Coma Score, ETAc: estimated time of arrival, TTAd: trauma team activation