Review of paediatric trauma admissions at the royal london hospital (February 98 to february 99)

The advantages of early trauma team activation in the management of major trauma patients who underwent exploratory laparotomy

Purpose

Trauma team activation (TTA) has been shown to have fundamental impact on trauma patients' outcomes. The purpose of this study was to evaluate the short-term outcomes of use of a new TTA protocol in the management of major trauma patients who underwent exploratory laparotomy.

Methods

The medical records of trauma patients who had been treated by the new TTA protocol (NT) over 18 months were compared with those of trauma patients treated by the old TTA protocol (OT) over 18 months. Comparisons between the two groups in terms of the time interval between accident and emergency room (ER) arrival, between ER arrival and CT scanning, between ER arrival and operating room (OR) presentation, between accident and OR presentation, mean intensive care unit (ICU) stay, mean hospital stay, mortality within 24 hours, mean mortality within one month, and overall mortality were performed using the Pearson chi-squared test and Student t-test.

Results

The time interval between accident and ER arrival, between ER arrival and CT scanning, between ER arrival and OR presentation, and between accident and OR presentation was found to have decreased significantly with the use of NT compared to OT. However, the mean ICU stay, mean hospital stay, mortality within 24 hours, mortality within one month, and overall mortality were found not to have improved.

Conclusion

While initiation of early TTA can shorten the time interval in the management of trauma patients, it may not improve patient outcomes.