Difference in trauma team activation criteria between hospitals within the same region

Objectives: The present study was conducted to establish the current criteria for trauma team activation (TTA) in hospitals in the Metropolitan Sydney area, and examine the rationale behind their use. Methods: A cross-sectional survey was undertaken of the seven hospitals in the Metropolitan Sydney area designated to receive adult major trauma in March 2004. Trauma coordinators in each hospital provided the criteria used for adult TTA within their hospital. Results: All seven hospitals replied with their TTA criteria and completed the survey. The results show a wide variation in those criteria used by hospitals to activate their trauma team. Universally used criteria included penetrating injury to the head, neck or torso, limb amputation, spinal cord injury and systolic blood pressure <90 mmHg. Physiological limits for TTA varied between hospitals, with different limits for pulse rate and GCS used in different hospitals. All hospitals used mechanism of injury criteria alone as an activation prompt. Conclusions: The criteria for TTA differ between hospitals within the same region. The criteria currently used will result in over-triage of trauma patients, but this might be of benefit in training the trauma team in centres that do not see a large volume of trauma patients. There are several advantages in standardization of criteria including optimization of patient care, training, research and audit. Further work is needed to validate existing criteria for use throughout the region.