Steigender Vorhalteaufwand für den Schockraum

Abstract

Every year up to 35,000 people in Germany are severely injured in accidents in traffic, during work or leisure activities. The 24-h availability of the trauma room as well as surgical and intensive care unit capacities are essential to provide optimal acute care. This study analyzed the frequency of utilization of the resource trauma room in alevel Itrauma center in the past. Data of a level Itrauma center from 2005 to 2016 including trauma room alerts deployed by the rescue coordination center and the number of patients found to be severely injured (ISS≥ 16) during trauma room diagnostics were analyzed retrospectively. Additionally, alerts due to trauma mechanism, accompanying by the emergency physician, ventilation and resuscitation were evaluated via aweb-based interdisciplinary care capacity system (IVENA) from 2012 to 2016. Therefore, acomparison between the number of trauma room alerts and the number of severely injured patients was performed for the time after 2012. For the time from 2012 to 2016, data obtained by IVENA showed acontinuous increase in the number of trauma room alerts (n = 367 to n = 623). At the same time, the number of patients admitted under resuscitation (n = 15 to n = 45) as well as ventilated patients (n = 78 to n = 139) increased significantly; however, there was also an increase in the number of trauma alerts due to trauma mechanisms (n = 84 to n = 194) as well as the number of patients admitted to the trauma room not accompanied by an emergency physician (n = 38 to n = 132). The ratio between the number of trauma room alerts and severely injured patients (ISS≥ 16) increased from 3.1 in 2012 to 5.4 in 2015 and 4.6 in 2016. The data at hand showed aconstant number of severely injured trauma patients admitted to alevel Itrauma center over the past few years. At the same time, there was asignificant increase in utilization of the trauma room; however, in aconsiderable number of patients admitted to the trauma room the diagnostic process resulted in non-traumatic diagnostic findings. In the analyzed cohort, especially patients admitted to the trauma room due to trauma mechanism or without an accompanying emergency physician contributed to this development, necessitating an increased operational readiness of the trauma room team.