Faculty Collaboration Database

A consensus-based criterion standard definition for pediatric patients who needed the highest-level trauma team activation. J Trauma Acute Care Surg 2015 Mar;78(3):634-8

Date

02/25/2015

Pubmed ID

25710438

Pubmed Central ID

PMC4341956

DOI

10.1097/TA.0000000000000543

Scopus ID

2-s2.0-84924137781 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

BACKGROUND: Verbal prehospital reports on an injured patient’s condition are typically used by trauma centers to determine if a trauma team should be present in the emergency department prior to patient arrival (i.e., trauma team activation). Efficacy studies of trauma team activation protocols cannot be conducted without a criterion standard definition for which pediatric patients need a trauma team activation.

OBJECTIVE: To develop a consensus-based criterion standard definition for pediatric patients who needed the highest-level trauma team activation.

METHODS: Ten local and national experts in emergency medicine, emergency medical services, and trauma were recruited to participate in a Modified Delphi survey process. The initial survey was populated based on outcomes that had been used in previously published literature on trauma team activation. The criterion standard definition for trauma team activation was refined iteratively based on survey responses until at least 80% agreement was achieved for each criterion.

RESULTS: After five voting rounds a consensus-based definition for pediatric trauma team activation was developed. Twelve criteria were identified along with a corresponding time interval in which each criterion had to occur. The criteria include receiving specific surgery types, interventional radiology, advanced airway management, thoracostomy, blood products, spinal injury, emergency cesarean section, vasopressors, burr hole or other procedure to relieve intracranial pressure, pericardiocentesis, thoracotomy, and death in the emergency department. All expert panel members voted in all 5 voting rounds, except 1 member missed rounds 1 and 2. Each criterion had greater than 80% agreement from the panel.

CONCLUSION: A criterion standard definition for the highest-level pediatric trauma team activation was developed. This criterion standard definition will advance trauma research by allowing investigators to determine the accuracy and effectiveness of highest-level pediatric trauma team activation protocols.

LEVEL OF EVIDENCE/STUDY TYPE: Qualitative

Author List

Lerner EB, Drendel AL, Falcone RA Jr, Weitze KC, Badawy MK, Cooper A, Cushman JT, Drayna PC, Gourlay DM, Gray MP, Shah MI, Shah MN

Authors

Patrick C. Drayna MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of Wisconsin
David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Consensus
Delphi Technique
Emergency Medical Services
Humans
Injury Severity Score
Patient Care Team
Pediatrics
Quality Indicators, Health Care
Trauma Centers
Traumatology
United States
Wounds and Injuries