J Korean Soc Emerg Med.  2020 Feb;31(1):39-44.

Is it reasonable emergency department doctor must activate the whole trauma team if they meet the patients who fell above 20 feet?

• Tae W
• Bae B
• Wang I
• Han S
• Park S
• Kim H
• Jo Y
• Park S
• Lee S

Abstract

Objective
Many trauma centers use their own criteria for major trauma patients, and these criteria are organized according to physiological causes and their related mechanisms. Mechanism related criteria have high sensitivity but low specificity. We confirmed 20 feet as a single factor for trauma team activation criteria.
Methods
This study was retrospectively conducted in the Pusan National University Hospital trauma center, which is a level 1 trauma center in Busan. Patients were grouped as group 1, a fall from less than 20 feet; and group 2, a fall from more than 20 feet. We compare the two groups of prognostic factors using logistic regression analysis.
Results
The relationship between the height of the fall and the patient’s prognosis showed a positive relationship on the logistic regression analysis. Yet the cut-off value of a 20 foot height showed poor predictive power for the patient’s prognosis.
Conclusion
In conclusion, as trauma team activation criteria, a 20 foot height seems to be a reasonable aspect of patients’ clinical prognosis between above 20 feet and below 20 feet. Yet it seems to be controversial as a cut-off value. Thus, more studies will be needed to identify a specific height for trauma team activation.

Keyword

Trauma; Mechanism of injury; Patients who had falled; Decide to trauma team activation; ISS and height of fall