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Resource Deployment in Response to Trauma Patients

Thomas Matthews, Alexa LaScala, Theresa Tomkin, Lisa Gaeta,Karen Fitzgerald, Michele Solomita, Barbara Ragione, Taslima P. Jahan, Saliha Pepic, Lillian Apurillo,Victoria Siegel, Amy Frederick,Abenamar Arrillaga,Lauren R. Klein, John Cuellar,Christopher Raio, Keri Penta,Lauren Rothburd,Sarah A. Eckardt,Patricia Eckardt

Cureus(2023)

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Abstract
BackgroundVariance in the deployment of the trauma team to the emergency department (ED) can result in patient treatment delays and excess burden on ED personnel. Characteristics of trauma patients, including mechanism of injury, injury type, and age, have been associated with differences in trauma resource deployment. Therefore, this retrospective, single-site study aimed to examine the deployment patterns of trauma resources, the characteristics of the trauma patients associated with levels of trauma resource deployment, and the deployment impact on ED workforce utilization and non-trauma ED patients. MethodologyThis was an investigator-initiated, single-institution, retrospective cohort study of all patients designated as a trauma response and admitted to a community hospital's ED from July 01, 2019, through July 01, 2022. ResultsResource deployment for trauma patients varied by mechanism of injury (p < 0.001), injury type (p < 0.001), and patient age groups (p < 0.001). Specifically, there was a lower average trauma activation for geriatric trauma patients with a fall as a mechanism of injury compared to all younger patient groups with any mechanism of injury (F(5) = 234.49, p < 0.001). In the subsample, there was an average of 3.35 ED registered nurses (RNs) allocated to each trauma patient. Additionally, the ED RNs were temporarily reallocated from an average of 4.09 non-trauma patients to respond to trauma patients, despite over a third of the trauma patients in the subsample being the trauma patients being discharged home from the ED. ConclusionsTrauma activation responses need to be standardized with a specific plan for geriatric fall patients to ensure efficient use of trauma and ED personnel resources.
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Key words
geriatric trauma,trauma team,falls trauma,trauma deployment,trauma activation,emergency staff deployment
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