IMPACT OF A 2-TIERED TRAUMA RESPONSE IN THE EMERGENCY DEPARTMENT - PROMOTING EFFICIENT RESOURCE UTILIZATION

Objective: The purpose of this prospective study was to assess the imp act of a two-tiered trauma response protocol on the expediency of iden tification, evaluation, and treatment of trauma patients in the Emerge ncy Department. Materials and Methods: At a Level I Trauma Center serv ing a suburban/urban population of approximately one million people, E mergency Department length of stay was tabulated for all consecutive T rauma Service admissions 6 months before and 6 months after implementa tion of a two-tiered trauma response protocol, This protocol, which us es specific triage criteria, consisted of the standard Surgery-supervi sed trauma code response and an additional Emergency Medicine-supervis ed trauma alert response. Results: Trauma Service admissions numbered 532 in the pre-protocol period and 512 in the period after implementat ion of the protocol, In the first period, the Emergency Department len gth of stay was 289 minutes; in the second period, it was 241 minutes, Of the 512 patients in the post-protocol period, 183 were triaged to the new trauma alert group, reducing the number of Trauma Service cons ultations and decreasing Emergency Department length of stay by 139 mi nutes, The two levels of trauma response allowed accurate identificati on of the most seriously injured patients and improved the ability to predict those patients who would require direct disposition to the ope rating room or intensive rare unit. Conclusions: Implementation of a t wo-tiered trauma response significantly decreased Emergency Department length of stay, allowed Emergency Medicine physicians to more rapidly identify, evaluate, and treat trauma patients requiring hospitalizati on, improved identification of patients requiring operating room or in tensive care unit resources, and was time efficient and resource effic ient.