Effectiveness of a pediatric trauma team protocol

Objective: To determine the effectiveness of a pediatric trauma triage syst em and resource allocation for emergency medicine and trauma services. Trauma System: Two-tier trauma team activation system that triages patients into Level 1 and Level 2 trauma alert categories based on information prov ided by pre-hospital providers to pediatric emergency physicians at an Amer ican College of Surgeons' Level 1 pediatric trauma center in Columbus, Ohio . Methods: Using the hospital trauma registry database and patient medical re cords, a retrospective chart review was conducted on all (n = 542) admitted pediatric trauma patients from January 1995 through December 1996, Results: Level 1 patients had a higher median injury severity score and sho rter emergency department (ED) length of stay time than Level 2 patients. L evel 1 patients mere more likely to be admitted to the pediatric intensive care unit and remain for more than 24 hours when compared to Level 2 patien ts, In addition, Level 1 patients were more Likely to have procedures perfo rmed leg, intubation, tube thoracostomy, thoracotomy, diagnostic peritoneal lavage) than Level 2 patients, The mortality rate was significantly higher for Level 1 patients and all ED deaths had been triaged to the Level 1 cat egory. Conclusions: This pediatric trauma triage system effectively predicts which patients will be more likely to have serious injury. By using a two-tier s ystem, select patients may be managed by a smaller trauma team, thus improv ing staff utilization and possibly reducing costs while ensuring favorable outcomes.