Emerg Med J 26:864-865 doi:10.1136/emj.2008.067546
  • Original Article

Protocol-driven trauma resuscitation: survey of UK practice

  1. J M S Andrews1,
  2. E J Dickson2,
  3. M A Loudon1,
  4. J O Jansen1
  1. 1
    Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
  2. 2
    Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Mr Jan O Jansen, Department of Surgery, Ward 34, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK; jan.jansen{at}
  • Accepted 16 March 2009


Objective: To evaluate the use of protocol-driven trauma resuscitation strategies in UK emergency departments.

Methods: Postal/internet questionnaire survey of emergency departments to evaluate the existence of guidelines or protocols to direct resuscitation, blood component treatment, second line imaging of patients who had major trauma and the existence of a trauma team/trauma call system.

Results: 243 departments were identified and contacted, 183 responded. Five replies were excluded. Of the remaining 178 departments, 139 (78.1%) had a trauma team or trauma call system, but only 49 (27.5%) had a guideline or protocol for resuscitation. 92 (51.7%) had guidelines or protocols for blood component treatment in trauma, and 88 (49.4%) had guidelines or protocols for the use of second line imaging in trauma. The use of protocols and guidelines did not correlate with emergency department size, as measured by volume of activity.

Conclusions: The utilisation of trauma resuscitation protocols and guidelines in British emergency departments is limited. Given the clear benefits of these strategies, consideration should be given to greater integration of such algorithms into practice.


  • Funding Funding for the cost of obtaining a database of emergency departments in the UK and for postage costs came from a department fund.

  • Competing interests None.

  • Previous presentation: An abstract of this work was presented as a poster at the Association of Surgeons of Great Britain and Ireland annual scientific meeting in May 2008.

  • Contributors and guarantor: MAL, JOJ and EJD conceived the idea for the study. JOJ designed the questionnaire, set up the online survey and contributed to the writing of the article. JMSA mailed out the questionnaires, collated the results, performed the statistical analysis and contributed to the writing of the article. MAL and EJD edited the manuscript. JOJ is the guarantor.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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