Emergency intervention rate in the emergency room depending on the alerting criteria Prospective data analysis of a supraregional trauma center

Trauma team alert (TTA) to the emergency room (ER) takes place in the event of disturbed vital signs or serious injuries (A criteria) or after a dangerous accident (B criteria). Due to low specificity and limited personnel resources, TTA is questioned for B criteria. The consequences would be an increase in undertriage and thus endangering patients. Due to the lack of data it is unclear whether adapted ER teams would be a solution to the problem. The aim of the study was to describe ER patients according to the TTA criteria and to collect the corresponding emergency intervention rates in ER. Over 1 year, all TTAs of a supraregional trauma center were prospectively recorded, categorized according to TTA criteria (A, B and NULL criteria) and compared descriptively. NULL criteria were TTAs for which neither A nor B criteria were met. Treatment data were documented according to the TraumaRegister DGU (R) standard form. Emergency interventions were intubation, chest tube, cardiopulmonary resuscitation, transfusion, coagulation substitution, external pelvic stabilization and surgical hemostasis. The TTA due to A, B and NULL criteria were performed in 19.5%, 51.2% and 29.3%, respectively. The mean injury severity (ISS +/- standard deviation) was 20.6 +/- 21.3 for A criteria, significantly higher than for B criteria (8.0 +/- 7.1) and NULL criteria (5.6 +/- 8.2). The emergency intervention rate for A , B and NULL criteria was 75%, 6% and 2.1%, respectively. Differentiation according to the TTA criteria results in patient collectives with different injury severity and emergency intervention rates. This result justifies considerations to adjust team composition based on TTA criteria, as long as it is ensured that critical conditions can be identified and remedied by adapted teams.