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Observation unit admission as an alternative to inpatient admission for trauma activation patients
  1. T E Madsen,
  2. J R Bledsoe,
  3. P J Bossart
  1. University of Utah, Salt Lake City, Utah, USA
  1. Dr T E Madsen, University of Utah, 30 N 1900 E 1C26, Salt Lake City, UT 84132, USA; troy.madsen{at}


Background: At this 35 000 visits/year emergency department (ED) at a level one trauma centre, a trauma protocol was implemented for the ED observation unit. Data on all trauma observation unit admissions were then collected to evaluate for safety, efficiency and admission rates.

Methods: A retrospective chart review was performed of all trauma patients in the observation unit during a 14-month period. Exclusion criteria for observation unit admission included: abnormal vital signs, positive focussed abdominal sonography for trauma examination, abnormal ECG, abnormal chest radiograph, abnormal head computed tomography, Glasgow coma score less than 14, or multisystem trauma.

Results: 364 trauma patients were admitted to the observation unit. 84.6% were trauma II activations and 3.8% were trauma I activations. There were no deaths, intubations, loss of vital signs or other adverse events. The average length of stay was 12 h 46 minutes and 11.5% of patients were admitted to an inpatient unit. At 30-day follow-up, there were no significant missed injuries.

Conclusion: The observation unit is a safe alternative to inpatient admission for the evaluation of the minimally injured trauma activation patient.

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  • Competing interests: None.

  • Ethics approval: The study received approval from the hospital’s institutional review board in October 2007.