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Trauma-team-activation in Germany: how do emergency service professionals use the activation due to trauma mechanism? Results from a nationwide survey

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background

Trauma team activation (TTA) requires significant human and financial resources. The implemented German guidelines reduced the mortality of severe injured patients significantly over the last decade. Up to now there is no two-tier trauma team activation protocol in Germany. A two-tier TTA [often activated due to trauma mechanism (TM)] is thought to be a reasonable way to maintain patient safety while increasing cost efficiency.

Methods

We created an online survey addressed at the Emergency Medical Service in Germany to conduct a cross-sectional study. Both physicians and rescue service professionals (RSPs) were included. A minimum of 1550 participants answered questions in 4 different categories concerning the aspects of limited-TTA (L-TTA). Case studies were presented to evaluate the usage of TTA due to TM in the daily routine.

Results

Eighty percent (n:1233) of the respondents wish for a possibility to activate a limited trauma team. Seventy-two percent (n: 1109) of the participants consider a L-TTA due to TM to be adequate. There were significant differences (p < 0.05) in the assessment and opinion on L-TTA among physicians and RSPs as well as different medical professions. The evaluated case studies showed diverse answers: depending on the profession, the same patient was ranked as severely injured by 54% and as minorly injured by 46% of the 1550 participants.

Conclusions

Members of the German Emergency Medical Service call for a two-tier TTA-protocol. Up to now we cannot fully recommend an automatic reduction of the trauma team when activated due to TM in Germany with the guidelines implemented. The profession might affect the L-TTA-behavior. Criteria for a L-TTA in Germany have to be defined and evaluated.

Level of evidence

IV, cross-sectional study.

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Data availability

The dataset generated and analyzed during the current study is not publicly accessible, but is available from the corresponding author on reasonable request.

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Funding

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Author notes

  1. Paul Hagebusch and Philipp Faul contributed equally to this work.

Authors and Affiliations

  1. Department of Trauma and Orthopedic Surgery, BG Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt, Germany

    Paul Hagebusch, Philipp Faul, Alexander Klug, Reinhard Hoffmann & Uwe Schweigkofler

  2. Ministry of Health, City of Frankfurt, Breite Gasse 28, 60313, Frankfurt, Germany

    Frank Naujoks

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  1. Paul Hagebusch
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  2. Philipp Faul
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  6. Uwe Schweigkofler
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Contributions

PH (BG Unfallklinik Frankfurt am Main—Department of Trauma and Orthopedic Surgery) is the corresponding author. PF (BG Unfallklinik Frankfurt am Main—Department of Trauma and Orthopedic Surgery) made substantial contributions to the conception, the design of the work, the acquisition, the analysis and interpretation of data and was a major contributor in writing the manuscript. AK (BG Unfallklinik Frankfurt am Main—Department of Trauma and Orthopedic Surgery) made substantial contributions to the conception, the design of the work, the acquisition, the analysis and interpretation of data. FN (Ministry of Health—City of Frankfurt) made substantial contributions to the conception and the design of the work. RH (BG Unfallklinik Frankfurt am Main—Department of Trauma and Orthopedic Surgery) made substantial contributions to the conception and design of the work and substantively revised it. US (BG Unfallklinik Frankfurt am Main—Department of Trauma and Orthopedic Surgery) made substantial contributions to the conception, the design of the work, the acquisition, the analysis and interpretation of data and substantively revised it. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paul Hagebusch.

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Hagebusch, P., Faul, P., Naujoks, F. et al. Trauma-team-activation in Germany: how do emergency service professionals use the activation due to trauma mechanism? Results from a nationwide survey. Eur J Trauma Emerg Surg 48, 393–399 (2022). https://doi.org/10.1007/s00068-020-01425-x

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