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Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?

BACKGROUND: Trauma team activation (TTA) is paramount in the early hospital management of trauma patients. This study aimed to evaluate factors which contribute to failure to activate the Trauma team for management of paediatric trauma. METHODS: A retrospective cohort study of Emergency Department (...

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Autores principales: Sung, Jonghoo, Yao, Angela, Antoniou, Georgia, Cooksey, Rebecca, Winters, Jacqueline, Ee, Michael, Williams, Nicole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796087/
https://www.ncbi.nlm.nih.gov/pubmed/35833510
http://dx.doi.org/10.1111/ans.17906
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author Sung, Jonghoo
Yao, Angela
Antoniou, Georgia
Cooksey, Rebecca
Winters, Jacqueline
Ee, Michael
Williams, Nicole
author_facet Sung, Jonghoo
Yao, Angela
Antoniou, Georgia
Cooksey, Rebecca
Winters, Jacqueline
Ee, Michael
Williams, Nicole
author_sort Sung, Jonghoo
collection PubMed
description BACKGROUND: Trauma team activation (TTA) is paramount in the early hospital management of trauma patients. This study aimed to evaluate factors which contribute to failure to activate the Trauma team for management of paediatric trauma. METHODS: A retrospective cohort study of Emergency Department (ED) presentations at the paediatric major trauma hospital in Adelaide, South Australia was conducted over a 16‐month period. Data from the hospital's trauma registry, individual case files and digital medical records were evaluated to determine factors that were associated with no TTA. RESULTS: During the study period, 617 trauma patients who met Level 1 or Level 2 TTA criteria attended the trauma centre. For 29 (4.7%) of these patients, there was no TTA. Predictors of no TTA included sustaining abdomen and/or pelvis injuries compared to limb injuries (unadjusted odds ratio [OR] = 10.59, 95% confidence interval [CI] 1.98–56.69, P = 0.006), sustaining non‐accidental injury (NAI) versus an injury with vehicle involvement (OR = 30.13, 95% CI 6.43–141.21, P < 0.001), and arriving via emergency medical retrieval service compared to private vehicle (OR = 14.23, 95% CI 3.94–51.36, P < 0.001). No patients transferred directly to Paediatric Intensive Care Unit (PICU), or High Dependency Unit (HDU) received an appropriate TTA. CONCLUSION: Multiple factors were associated with no TTA in paediatric trauma patients. The results highlight that even in PICU and HDU admissions and transfer patients, vigilant clarification of mechanism of injury and potential for occult injuries should be undertaken to ensure appropriate TTA and improve patient outcome.
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spelling pubmed-97960872022-12-28 Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out? Sung, Jonghoo Yao, Angela Antoniou, Georgia Cooksey, Rebecca Winters, Jacqueline Ee, Michael Williams, Nicole ANZ J Surg Trauma Surgery BACKGROUND: Trauma team activation (TTA) is paramount in the early hospital management of trauma patients. This study aimed to evaluate factors which contribute to failure to activate the Trauma team for management of paediatric trauma. METHODS: A retrospective cohort study of Emergency Department (ED) presentations at the paediatric major trauma hospital in Adelaide, South Australia was conducted over a 16‐month period. Data from the hospital's trauma registry, individual case files and digital medical records were evaluated to determine factors that were associated with no TTA. RESULTS: During the study period, 617 trauma patients who met Level 1 or Level 2 TTA criteria attended the trauma centre. For 29 (4.7%) of these patients, there was no TTA. Predictors of no TTA included sustaining abdomen and/or pelvis injuries compared to limb injuries (unadjusted odds ratio [OR] = 10.59, 95% confidence interval [CI] 1.98–56.69, P = 0.006), sustaining non‐accidental injury (NAI) versus an injury with vehicle involvement (OR = 30.13, 95% CI 6.43–141.21, P < 0.001), and arriving via emergency medical retrieval service compared to private vehicle (OR = 14.23, 95% CI 3.94–51.36, P < 0.001). No patients transferred directly to Paediatric Intensive Care Unit (PICU), or High Dependency Unit (HDU) received an appropriate TTA. CONCLUSION: Multiple factors were associated with no TTA in paediatric trauma patients. The results highlight that even in PICU and HDU admissions and transfer patients, vigilant clarification of mechanism of injury and potential for occult injuries should be undertaken to ensure appropriate TTA and improve patient outcome. John Wiley & Sons Australia, Ltd 2022-07-14 2022-10 /pmc/articles/PMC9796087/ /pubmed/35833510 http://dx.doi.org/10.1111/ans.17906 Text en © 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Trauma Surgery
Sung, Jonghoo
Yao, Angela
Antoniou, Georgia
Cooksey, Rebecca
Winters, Jacqueline
Ee, Michael
Williams, Nicole
Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title_full Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title_fullStr Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title_full_unstemmed Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title_short Failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
title_sort failure to initiate trauma team activation for patients who meet the criteria in a level 1 paediatric trauma centre: which patients are missing out?
topic Trauma Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796087/
https://www.ncbi.nlm.nih.gov/pubmed/35833510
http://dx.doi.org/10.1111/ans.17906
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