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Fri May 4 19:16:15 BST 2007

Charles,

I can tell you that a whole lot of places DO NOT use mechanism.  Having said that, here is what we use at Hartford.  Clearly, MD discretion will play a part as to whether a patient is indeed activated, and the decision can even be made or changed (1) at triage or (2) after the trauma team arrives and after discussion with the ED attending, decides that the patient can be downgraded and worked up by the ED attending/residents.  If necessary, a trauma consult can then be asked for. 

Hope this helps.  Give me a call off line if you want.

Take care,
Ron
>>> "Morrow, Charles" <cmorrow at srhs.com> 5/4/2007 11:32 AM >>>
Do most/some/none Level I trauma centers use mechanism alone as a criteria for full trauma team activation?  For those on the list with experience with the ACS verification process, if you do not activate the full trauma team for mechanism only, is this or has it been used as a criteria for deficiency?  In reading the Green book (and Gold Book) it seems to suggest that unless there is a quality issue and patients with serious injuries are being missed, it is reasonable to have patients brought to a level I trauma center seen by a qualified EM Attending first and the trauma team requested as needed if there is no hemodynamic derangement and the only issue is a serious mechanism.  Obviously having this issue at my shop and would appreciate input.

Charles E. Morrow, MD  FACS

Director of Trauma 

Spartanburg Regional Medical Center

864.560.1576

cmorrow at srhs.com 

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