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Purpose <p>This study examines secondary trauma transfers of critically injured patients to an adult regional trauma centre in a mixed urban-suburban setting, to examine if these could be avoided through the provision of prehospital critical care at the scene of injury.</p> Methods <p>This is a cohort study of trauma activations at an adult regional trauma centre in Toronto, Canada, over a 5-year period. We included all secondary trauma transfers of patients who were either admitted to the ICU, had surgery within 4&#xa0;h of arrival or died within 48&#xa0;h of admission. Baseline demographics, injury data, geospatial data and interventions provided were extracted from the hospital’s trauma registry.</p> Results <p>659 cases met the inclusion criteria during the five-year study period. 364 (55%) patients underwent secondary transfer from non-trauma centres located in relatively close proximity of 80&#xa0;km or less. Within this group, patients had a median injury severity score of 22 (IQR 16–29) and the mortality was 17%. 188 (52%) received at least one critical care intervention at the sending facility prior to secondary transfer to the trauma centre. The most frequently performed interventions were emergency anesthesia and intubation (37%), blood transfusion (27%), and finger and/or tube thoracostomy (13%).</p> Conclusion <p>A significant proportion of critically injured patients in our mixed urban-suburban trauma network are transferred from non-trauma hospitals in relatively close proximity to the trauma centre. Non-trauma hospitals frequently provide time-critical and life-saving interventions prior to secondary transfer. A prehospital critical care scene response for major trauma should be explored as an option to deliver critical care interventions at the scene, followed by direct transport to a trauma centre.</p>

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Analysis of secondary trauma transfers within a Canadian regional trauma network: room for improvement?

  • 期刊论文

  • 发表日期：

    2025年4月16日

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  • Ryan McAleer,
  • Rachel Stephenson,
  • Melissa McGowan,
  • Brodie Nolan,
  • Johannes von Vopelius-Feldt,
  • Steve Lin,
  • Sheldon Cheskes,
  • Ian Drennan,
  • Garrick Mok,
  • Andrew Beckett,
  • Brodie Nolan

摘要

Purpose

This study examines secondary trauma transfers of critically injured patients to an adult regional trauma centre in a mixed urban-suburban setting, to examine if these could be avoided through the provision of prehospital critical care at the scene of injury.

Methods

This is a cohort study of trauma activations at an adult regional trauma centre in Toronto, Canada, over a 5-year period. We included all secondary trauma transfers of patients who were either admitted to the ICU, had surgery within 4 h of arrival or died within 48 h of admission. Baseline demographics, injury data, geospatial data and interventions provided were extracted from the hospital’s trauma registry.

Results

659 cases met the inclusion criteria during the five-year study period. 364 (55%) patients underwent secondary transfer from non-trauma centres located in relatively close proximity of 80 km or less. Within this group, patients had a median injury severity score of 22 (IQR 16–29) and the mortality was 17%. 188 (52%) received at least one critical care intervention at the sending facility prior to secondary transfer to the trauma centre. The most frequently performed interventions were emergency anesthesia and intubation (37%), blood transfusion (27%), and finger and/or tube thoracostomy (13%).

Conclusion

A significant proportion of critically injured patients in our mixed urban-suburban trauma network are transferred from non-trauma hospitals in relatively close proximity to the trauma centre. Non-trauma hospitals frequently provide time-critical and life-saving interventions prior to secondary transfer. A prehospital critical care scene response for major trauma should be explored as an option to deliver critical care interventions at the scene, followed by direct transport to a trauma centre.