Abstract

BackgroundPre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient actually arrives. In the present study we retrospectively analyzed the pre-hospital information provided by 700 consecutive pre-notification mobile phone calls in terms to asses the response of trauma team activation regard to pre-notified information such as vital signs and level of consciousness, mechanism of injury (MOI), and estimated elapsed time (EET) from the time of pre-notification phone call to arrival.ResultsThe median EET was 15 minutes (range 0 – 80 min, interquartile range 10 – 20 min). In 11% of the cases EET was 5 minutes or shorter. 17% of the patients were intubated and ventilated on scene at the time pre-notification phone call took place. The most commonly notified pre-hospitally diagnosed injuries were thoracic in 75 cases (11%), followed by unstable long bone (tibia, femur, humerus) fracture in 66 cases (9%), and abdominal injuries in 32 cases (5%). Trauma team was activated for 61% of 700 pre-notified patients. MOI without clinical symptoms was the reason for team activation in 75% of the cases. In 25% of the cases there were pre-hospitally observed clinical injuries or abnormalities in vital parameters.ConclusionPre-notification phone call is of a crucial importance in organizing every day activities at a busy trauma centre, but it should not take place in too much advance. In any case, a pre-notification phone call, even on short notice, gives emergency department personnel some time to prepare for the incoming patient.

Highlights

  • Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient arrives

  • Pre-notification information is routinely collected on special form developed for the purpose, focusing on the issues related to the mechanism of injury (MOI), vital signs (VS) and LOC, anatomic injury (AI), and the elapsed time (EET) (median, range, interquartile range (IQR))

  • The present study focuses only on the crucial information provided by emergency medical system (EMS) before the arrival of trauma patient

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Summary

Introduction

Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient arrives. Mortality is associated with undertriage (that is, not to transport all patients to trauma centre who would benefit from it) [1]. Ambulance-hospital pre-notification of impending arrival of trauma patient to the emergency department (ED) is of crucial importance. Pre-notification gives the ED few minutes to judge the level of needed preparation maneuvers, including the decision whether to activate the trauma team or not. The benefit of appropriate pre-notification is documented in care of stroke patients and acute myocardial infarction patients by shortening the door to medical review and the door to needle time, respectively [4,5]

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