Table 3 Description and definition of 8 appropriate actions selected as process guidelines for severe trauma patients

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