Secondary Emergency Department Triage (Supertriage) and Trauma Team Activation

Abstract
Background Not all field triage patients need full trauma team activation. Secondary emergency department (ED) triage (supertriage), a clinical and anatomic screen, determines trauma team versus ED management. The purpose was to study the effects of supertriage on injury severity and disposition by patients managed with and without team activation. Methods Observational study of consecutive patients transported for alert consideration undergoing supertriage by a trauma nurse. Chart review was performed for disposition and Injury Severity Score. Contingency table or t test with p <or=to 0.05 was used for data analysis. Results One hundred ninety patients were screened; 74% of the 54 with positive supertriage and team activation needed the operating room in 24 hours or the intensive care unit versus 46% of cases with negative supertriage managed in the ED and admitted (p = 0.015). Of the 35 admitted ED patients, 10 required the operating room and 6 required the intensive care unit. Conclusions Supertriage identified a majority requiring team activation; however, resources must be available for the seriously injured not meeting field or hospital triage criteria.