Evaluation of a university hospital XXXX team activation protocol.

@entity1 @entity542 @entity174 @entity130
BACKGROUND: Admission with a multidisciplinary @entity130 team may be vital for the severely injured @entity1 , as this facilitates rapid diagnosis and treatment. On the other hand, @entity1 with minor injuries do not need the @entity130 team for adequate care. Correct triage is important for optimal resource utilization. The aim of the study was to evaluate our criteria for activating the @entity130 team, and identify suboptimal criteria that might be changed in the interest of precision. METHODS: The study is an observational, retrospective cohort-study. All @entity1 admitted with the @entity130 team (n = 382), all severely injured (Injury Severity Score (ISS) >15) (n = 161), and all undergoing an emergency procedure aimed at counteracting compromised airways, respiration or circulation at our hospital (n = 142) during 2006-2007 were included. Data were recorded from the admission records and the electronic @entity1 records. The @entity130 team activation protocol was evaluated against the occurrence of severe injury and the occurrence of emergency procedures. RESULTS: A total of 441 @entity1 were included. The overtriage was 71% and undertriage 32% when evaluating against ISS >15 as the standard of reference. When occurrence of emergency procedures was held as the standard of standard of reference, the over- and undertriage was 71% and 21%, respectively. Mechanism of injury-criteria for @entity130 team activation contributed the most to overtriage. The emergency procedures performed were mostly endotracheal intubation and external fixation of @entity174 . Less than 3% needed haemostatic laparotomy or thoracotomy. Approximately 2/3 of the overtriage represented isolated head or cervical spine injuries, and/or interhospital transfers. CONCLUSIONS: The over- and undertriage of our protocol are both too high. To decrease overtriage we suggest omissions and modifications of some of the criteria. To decrease undertriage, transferred @entity1 and @entity1 with @entity542 should be more thoroughly assessed against the @entity130 team activation criteria.
