Trauma Activations and Their Effects on Non-Trauma Patients

Abstract

Trauma patients consume many resources in the emergency department (ED), but what effect their care may have upon other patients seeking care is unclear. We sought to determine whether the presentation of trauma patients to the ED diverts staff and resources away from non-trauma patients. We hypothesized that the admission of trauma patients to the ED would result in longer times to physician evaluation and completion of laboratory and imaging studies, as well as a longer length of stay in the ED. This retrospective study reviewed and compared the charts of two groups of non-trauma ED patients. The group affected by trauma arrived up to 30 min after a trauma activation. The group unaffected by trauma arrived >3 h before or 3 h after a trauma activation. Times from arrival to initial MD evaluation, X-ray study, and computed tomography (CT) scan were documented. Median times from order to completion of laboratory results and imaging were compared, as well as total ED lengths of stay (LOS). Median time from arrival to MD evaluation for patients affected by a trauma activation was almost twice as long as for unaffected patients (42 vs. 23 min, respectively; p < 0.001). Times from arrival to X-ray study, CT scan order, and laboratory results were all significantly greater for patients affected by a trauma activation (p < 0.001). For patients who required admission to the hospital, the affected group had a median LOS that was increased by 16 min (224 vs. 208 min, respectively) when compared to unaffected patients (p = 0.04). In the setting studied, the arrival of a trauma patient delayed physician evaluation and diagnostic testing. It only modestly increased the ED LOS for patients needing hospital admission.