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Worldwide snapshot of trauma team structure and training: an international survey

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Abstract

Introduction

Trauma teams (TTs) are a key tool in trauma care, as they bring a multidisciplinary approach to the trauma patient, improving outcomes. Excellent teamwork (TW) requires not only individual skills but also training at non-technical skills (NTS). Although there is evidence supporting TTs, there is little information regarding how they are organized and trained. With this study, we intend to assess the reality of TTs all over the world, focusing on how they are organized and trained.

Materials and methods

We composed a 42-question sheet on Google Forms, in four different languages (English, Polish, Portuguese, and Spanish). The questions regarded the respondents’ background, and their respective hospitals’ trauma patient management, TT features and its training, NTS and TW. The survey was shared on social media, through the International Assessment Group of Online Surgical & Trauma Education community, and the European Society of Trauma and Emergency Surgery. Statistical analysis was performed on Statistical Package for the Social Sciences (SPSS®) version 27.

Results

We obtained 296 answers from 52 different countries, with 6 having at least 10 answers (Brazil, Portugal, Poland, Spain, Italy, and USA). While the majority of the respondents (97%) agreed that TTs can improve outcomes, only 61% have a TT in their hospital, with 69% of these being dedicated TTs. General surgery (76%), trauma surgery (68%), and anesthesia (66%) were the three most common specialties in the teams. Teams performed briefings and debriefings with a frequency of, at least, “often” in only 49% and 38%, respectively. Only 50% and 33% of the respondents stated that their hospital provided trauma management courses focusing on individual technical skills, and TT training courses, respectively. The Advanced Trauma Life Support (85%), the Definitive Surgical and Anesthetic Trauma Care (38%), and the European Trauma Course (31%) were the three trauma management courses of choice. Regarding TT training courses, the European Trauma Course (52%) and local/in-house (42%) courses were the most common ones. Most participants (93%) stated that NTS were highly important in trauma care. However, only 60% of the respondents had postgraduate training on NTS and TW, and only 24% had this type of training on an undergraduate level.

Conclusion

The number of TTs worldwide does not match their relevance in trauma care. Institutions are not providing enough trauma courses, particularly TT training courses and NTS teaching. Implementing TT should include promotion of team courses, as well as team briefings and debriefings.

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Data availability

The dataset used in the current study (SPSS file) is available from the corresponding author on reasonable request.

Abbreviations

TT/TTs:

Trauma team/trauma teams

TW:

Teamwork

NTS:

Non-technical skills

TL:

Team leader

ATLS:

Advanced Trauma Life Support

ETC:

European Trauma Course

TS:

Trauma surgery

DSATC:

Definitive Surgical and Anesthetic Trauma Care

IAG-OSTE:

International Assessment Group of Online Surgical & Trauma Education

ESTES:

European Society of Trauma and Emergency Surgery

EM:

Emergency medicine

GS:

General surgery

ER:

Emergency room

DSTC:

Definitive Surgical Trauma Care

DATC:

Definitive Anesthetic Trauma Care

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Acknowledgements

Mariana Pinto for her contribution with the artwork. Helena Carvalho and Victor Böhmeke Picallo for the Spanish survey translation. The authors would like to thank the Associação Lusitana de Trauma e Emergência Cirúrgica (ALTEC), the Sociedade Brasileira de Atendimento Integrado ao Traumatizado (SBAIT), and the European Society of Trauma and Emergency Surgery (ESTES) for the help sharing our survey internationally.

Funding

No funding or grant support was received for this manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    André Bento

  2. Department of General Surgery, Hospital Central do Funchal, SESARAM, Funchal, Portugal

    Luís Ferreira

  3. General and Gastrointestinal Surgery, Royo Villanova Hospital, SALUD, Zaragoza, Spain

    Carlos Yánez Benitez

  4. Department of Medical Simulation, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland

    Piotr Koleda

  5. Division of Trauma Surgery, School of Medical Sciences (SMS), University of Campinas (Unicamp), Campinas, SP, Brazil

    Gustavo P. Fraga

  6. Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland

    Piotr Kozera

  7. Department of Anesthesiology, Centro Hospitalar do Médio Tejo, EPE, Tomar, Portugal

    Sérgio Baptista

  8. Head of Clinic (Consultancy in General and Emergency Surgery and Trauma), Private Practice Coimbra, Coimbra, Portugal

    Carlos Mesquita

  9. Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045, Coimbra, Portugal

    Henrique Alexandrino

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Correspondence to André Bento.

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Conflict of interest

André Bento, Luís Ferreira, Carlos Yánez, Piotr Koleda, Gustavo P. Fraga, Piotr Kozera, Sérgio Baptista, Carlos Mesquita, and Henrique Alexandrino have no conflict of interest in this manuscript.

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Bento, A., Ferreira, L., Yánez Benitez, C. et al. Worldwide snapshot of trauma team structure and training: an international survey. Eur J Trauma Emerg Surg 49, 1771–1781 (2023). https://doi.org/10.1007/s00068-022-02166-9

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