Trauma Team International is a corporation that specializes in rapid response medical services.

Contents OverviewA franchise of paramedics operating in the, Canada, and parts of Europe. Trauma teams can be summoned by dialing 911 on any phone, and can trace a call to its source. The client is billed from the moment you call until delivery to the hospital.A trauma team client may also opt to carry a deadman transmitter, which will activate and automatically signal a Trauma Team the moment the client's brainwave pattern falls into a coma state.The Trauma Team is composed of paramedics expertly trained in combat, who will go to any length to deliver their clients from harm. Those wealthy enough to afford a Trauma Team medical plan receive a card and implant.Business Model (2020) Full Body Life CoverageThis plan costs either $500 per month, or $5,550 with a yearly plan discount.In the event that a Trauma Team is dispatched, the customer/patient also had to pay E$100 for every minute until arrival at the nearest corporate hospital.

The purpose of the trauma team is to provide advanced simultaneous care from relevant specialists to the seriously injured trauma patient. When functioning well, the outcome of the trauma team performance should be greater than the sum of its parts.

Trauma teams have been shown to reduce the time taken for resuscitation, as well as time to CT scan, to emergency department discharge and to the operating room. These benefits are demonstrated by improved survival rates, particularly for the most severely injured patients, both within and outside of dedicated trauma centres. In order to ensure the best possible performance of the team, the leadership skills of the trauma team leader are essential and their non-technical skills have been shown to be particularly important. Team performance can be enhanced through a process of audit and assessment of the workings of the team and the evidence currently available suggests that this is best facilitated through the process of video review of the trauma resuscitation. The use of human patient simulators to train and assess trauma teams is becoming more commonplace and this technique offers a safe environment for the future education of trauma team staff.Trauma teams are a key component of most programmes which set out to improve trauma care. This article reviews the background of trauma teams, the evidence for benefit and potential techniques of performance assessment.

The review was written after a PubMed, Ovid, Athens, Cochrane and guideline literature review of English language articles on trauma teams and their performance and hand searching of references from the relevant searched articles. Trauma is the leading cause of death in the 1-44 year old age group and the fourth leading cause of death in the western world. Despite the widespread recognition of simple principles of trauma care which have the potential to reduce mortality and the implementation of trauma education initiatives such as the American College of Surgeons Advanced Trauma Life Support courses (ATLS ®) , the uptake and implementation of many of these principles has been sporadic and variable. In the UK for example, The Royal College of Surgeons of England highlighted important deficiencies in the management of severely injured patients in a report in 1988. A second report in 2000 addressed the lack of ongoing improvement in the last six years of the twentieth century , recommending amongst other things, the introduction of a system of trauma audit and the establishment of hospital trauma teams. In 2007 a report by the UK National Confidential Enquiry into Patient Outcomes and Death found that trauma teams were only available in 20% of hospitals, and a trauma team response was documented for only 59.7% of patients with injury severity scores (ISS) 16. The report strongly recommended that hospitals in the UK ensure that a trauma team is available twenty four hours a day, seven days a week.

This problem is not confined to the UK. Data from Australia in 2003 show that only 56% of adult trauma hospitals and 75% of tertiary paediatric hospitals which receive trauma provided a trauma team reception.The trauma team usually comprises a multidisciplinary group of individuals drawn from the specialties of anaesthesia, emergency medicine, surgery, nursing and support staff, each of whom provide simultaneous inputs into the assessment and management of the trauma patient, their actions being coordinated by a team leader.

The primary aims of the team are to rapidly resuscitate and stabilise the patient, prioritise and determine the nature and extent of the injuries and prepare the patient for transport to the site of definitive care, be that within or outside the receiving hospital. This 'horizontal' approach to trauma care aims to provide rapid input to a critically injured patient without the need to contact and request the presence of individual team members. This aims to reduce the time from injury to critical interventions and surgery. The original aim of the trauma team was to reduce the second peak of the trimodal distribution of death following trauma, by appropriately managing correctable disturbances to the airway, breathing and circulation, which, if well implemented, was predicted to reduce preventable deaths by 42%. The validity of the trimodal concept has since been questioned but the likely benefits of coordination and rapid assessment of the trauma victims by a trauma team are widely accepted.

The Structure of the Trauma TeamA typical trauma team composition is shown in Figure. It is important not to over-staff the trauma team; excessive numbers of people in the core team can lead to fragmentation, with individuals failing to adhere to the directions of the team leader.

Additional team members do not necessarily improve team function. There are wide regional and national variations in the composition of hospital trauma teams and there has been much work in assessing the optimal makeup and performance dynamics of the trauma team. The presence of a surgeon on the trauma team is considered by some to be essential. The availability of an attending trauma surgeon on the trauma team twenty four hours a day has been demonstrated to reduce resuscitation time and time to incision for emergency operations, but has not been demonstrated to impact on mortality. Many centres now have a tiered trauma team response according to the severity of injury of the trauma patient. The application of triggering systems attempts to ensure that the appropriate tier of trauma team response is activated. The triggering system usually depends on the reported mechanism of trauma, the assessed injuries or the derangement in physiology noted on examination –.

Information from pre-hospital care providers is useful for guiding the appropriate tier of response and for assembly and preparation of the trauma team. Although these triggering systems serve as useful guide as to when the team should be activated, a considerable rate of over-triage, in the region of 30 to 50%, is deemed essential to prevent any under-triage and therefore delays in mobilising the team where it is deemed essential. The leader of the trauma team must be experienced in the diagnosis and management of trauma patients and the likely pitfalls associated with dealing with severely injured patients.

This individual must also be comfortable directing and being responsive to other team members. Non technical skills such as leadership are particularly important ; a good team leader will change his leadership style according to the experience of the team and the severity of the trauma. Commonly the leader is an emergency physician, a surgeon or an intensivist-anaesthetist. Data comparing surgeons with other trauma team leaders such as emergency physicians, show no difference in the length of stay in the emergency department or in the actual or predicted survival of patients ,. The seniority of the physician present has been linked to team performance and is a key feature of trauma system development.

The Benefits and Pitfalls of a Trauma TeamTrauma systems have been shown to reduce mortality amongst the victims of trauma –. The trauma system is a multifaceted approach to trauma care involving professionals of many disciplines acting both pre-and in-hospital, within an organised model of care.

The trauma team represents only one facet of the trauma system and separating the relative merits or drawbacks of the trauma team in isolation of the trauma system is not straightforward.Data from Canada identifies that the involvement of the trauma team for patients with injury severity scores (ISS) 12 results in significantly better outcomes than if patients are dealt with on a service-by-service basis. Not only was performance better than predicted, but there were more unexpected survivors in the group managed by the trauma team. Patients managed by a trauma team had higher ISS scores, were older, with more motor vehicle collisions and received more secondary transfers from other (non-trauma centre) hospitals, all of which should adversely affect the outcomes from this group, making the impact of the trauma team perhaps even more noteworthy. The incorporation of several specialties into one team therefore appears to be more valuable in outcome terms than the sum of its parts. The introduction of a trauma team in a level I trauma centre has been shown to reduce overall trauma mortality rates from 6.0% to 4.1% (absolute risk reduction 1.9%; 95% confidence interval 0.7%-3.0%), and in those severely injured patients with ISS scores 25, from 30.2 to 22.0% (absolute risk reduction 8.3%; 95% confidence interval 2.1%-14.4%). Data shows that the trauma team also improves survival in hospitals not recognised as trauma centres.Trauma teams also reduce times from emergency department arrival to CT scan, to the operating room and to emergency department discharge, manifesting as improved survival amongst critically injured paediatric patients. The mortality benefit is however lost in paediatric patients who have less severe injuries.

Conversely, those patients who meet well established trauma call criteria, but who are not treated by the trauma team (i.e. The team was not called) have a higher mortality; 28% of all trauma patients fell into this category in a study of 2539 consecutive patients from China. Part of the benefit of the trauma team may be related to a reduction in time to definitive care (often haemorrhage control). When well organised, the trauma team has been shown to reduce total resuscitation time from 122 to 56 minutes. The introduction of a trauma team and a trauma service led to a ten fold reduction (4.3% to 0.46%) in delayed injury diagnosis in the setting of paediatric trauma in Salt Lake City , but the exact contribution of the trauma team to this improvement is not clear.Despite the huge associated socioeconomic burden of increased morbidity no data on the impact of the trauma team on morbidity exist. It is clearly very difficult to separate the impact of a trauma team on morbidity and isolate it from the care received from scene to hospital discharge - a lengthy and variable pathway for many severely injured patients.The initial phase of hospital care in the emergency room has been identified as the area where most preventable problems in trauma care occur. The trauma team is naturally implicated in many of these errors.

Common problems include errors or delays in treatment, diagnosis, and intervention. Inadequate system capacity and poor processes are also frequently implicated.

Data from Australia identify that 6.09 errors per fatal case occur in the emergency department with an alarming 3.47 errors directly contributing to patient death.In paediatric trauma resuscitation, 5.9 errors per case have been shown to occur but with no fatalities directly attributable to the resuscitation phase. Emergency room problems, errors or inadequacies are however less likely to occur in a trauma centre where 1.7 errors occurred per case as opposed to 5.1 per case in small regional hospitals (p.

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