Table 3

Description and definition of 8 appropriate actions selected as process guidelines for severe trauma patients
Actions
Actions for dispatch setting
11 One ambulance and a Mobile Medical Team (MMT) are dispatched
Actions for prehospital setting
12 The patient is ABCDE stabilised before the hospital is reached
13 A provisional/working diagnosis is formulated before the hospital is reached
14 The patient is transported to a level 1 trauma centre
Actions for emergency department (ED) setting
15 A complete trauma team is present in the trauma room when the patient arrives
16 The patient is ABCDE stabilised in the trauma room
17 A complete trauma series X-rays is made in the trauma room
18 A provisional diagnosis is confirmed or reformulated in the trauma room
Definitions
Includes:
ABCDE stabilisation in the prehospital setting Manual clearance of the airway, application of a cervical collar, application of oxygen, staunching the flow of blood, insertion of two intravenous lines, administering intravenous fluids, immobilisation on a backboard, connection of the patient to a monitor and covering of the patient.
ABCDE stabilisation in the trauma room setting Manual clearance of the airway, intubation, application of oxygen, staunching the flow of blood, insertion of two intravenous lines, administering intravenous fluids, pain medication, connection of the patient to a monitor and covering of the patient
Prehospital working diagnosis ABCDE (Airway and cervical spine, Breathing, Circulation, Disability, Exposure and Environment), symptoms, anatomical location of injury, trauma mechanism, Glasgow Coma Scale (GCS) score, Revised Trauma Score (RTS)
Trauma room working diagnosis Prehospital working diagnosis extended with:
1.Findings on the trauma series X-rays
2.Pediatric Trauma Score for juvenile patients
Complete trauma team 2 ED nurses, a trauma surgeon, an anesthesiologist, a radiologist and an X-ray laboratory assistant
Complete trauma series Rontgen Cervical spine, chest and pelvis

Hoogervorst et al.

Hoogervorst et al. BMC Health Services Research 2013 13:79   doi:10.1186/1472-6963-13-79

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