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A survey of trauma alert criteria and handover practice in England and Wales
  1. Henry Robert Budd1,
  2. Lawrence Maximilian Almond2,
  3. Keith Porter3
  1. 1Department of Accident and Emergency Medicine, University Hospital North Staffordshire, Staffordshire, UK
  2. 2Department of Neurosurgery, Birmingham Children’s Hospital, Birmingham, UK
  3. 3Department of Trauma and Orthopaedic Surgery, Selly Oak Hospital, Birmingham, UK
  1. Correspondence to:
 Dr H R Budd
 University Hospital North Staffordshire, 16 Rosemary Ednam Close, Hartshill, Stoke-on-Trent ST4 7NG, UK;traumastudy{at}


Introduction: Appropriate alerting of patients with trauma and informative handover are necessary to allow a smooth transition of care between the prehospital and hospital teams.

Aim: To identify current practice and areas that need to be improved to facilitate the transition from prehospital care to emergency department resuscitation.

Methods: A questionnaire postal study of 100 emergency departments and all 32 ambulance service trusts in England and Wales.

Results: Emergency departments returned 34 (34%) completed questionnaires, and ambulance trusts returned 16 (50%) completed questionnaires. In all, 56.8% of emergency department responders stated that trauma alert information was relayed through ambulance control, 48.5% stated that alert messages were standardised and 18.5% felt that ambulance crews used the trauma severity scoring system during alerting. 64.7% stated that handover was broadcast to the trauma team and 9.1% routinely received digital photographic images. All ambulance service responders included injury mechanism in their alerting criteria and 53.3% used a standard handover structure with 86.7% familiar with the mnemonic ASHICE (Age, Sex, History, Injuries, Condition, Expected time of arrival) for rapid information transmission.

Discussion: Greater cooperation between regional emergency departments and ambulance services is necessary to refine the alerting and handover process, producing a pathway through which vital information is collected by trained personnel and communicated without distortion to the resuscitation room, where it may be utilised to inform life-saving decisions.

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  • Funding: Department of Trauma and Orthopaedic Surgery, Selly Oak Hospital, Birmingham.

  • Competing interests: None.