State of the art of trauma teams in Italy: A nationwide study

Luca Carenzo; Cesare Mercalli; Elisa Reitano; Marco Tartaglione; Martina Ceolin; Stefania Cimbanassi; Daniele Del Fabbro; Fabrizio Sammartano; Maurizio Cecconi; Carlo Coniglio; Osvaldo Chiara; Lorenzo Gamberini

doi:10.1016/j.injury.2024.111388

State of the art of trauma teams in Italy: A nationwide study

Injury. 2024 May;55(5):111388. doi: 10.1016/j.injury.2024.111388. Epub 2024 Jan 27.

Authors

Affiliations

¹ Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano (MI), Italy. Electronic address: luca.carenzo@hunimed.eu.
² Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
³ Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
⁴ Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
⁵ Department of Trauma and Acute Care Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano (MI), Italy.
⁶ Trauma Team, ASST GOM Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Department of Pathophysiology and Transplants, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
⁷ Department of Trauma Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, 20162, Milan, Italy.
⁸ Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano (MI), Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.

PMID: 38316572
DOI: 10.1016/j.injury.2024.111388

Abstract

Trauma teams play a vital role in providing prompt and specialized care to trauma patients. This study aims to provide a comprehensive description of the presence and organization of trauma teams in Italy. A nationwide cross-sectional epidemiological study was conducted between July and October 2022, involving interviews with 137 designated trauma centers. Centers were stratified based on level: higher specialized trauma centers (CTS), intermediate level trauma centers (CTZ + N) and district general hospital with trauma capacity (CTZ). A standardized structured interview questionnaire was used to gather information on hospital characteristics, trauma team prevalence, activation pathways, structure, components, leadership, education, and governance. Descriptive statistics were used for analysis. Results showed that 53 % of the centers had a formally defined trauma team, with higher percentages in CTS (73 %) compared to CTZ + N (49 %) and CTZ (39 %). The trauma team activation pathway varied among centers, with pre-alerts predominantly received from emergency medical services. The study also highlighted the lack of formally defined massive transfusion protocols in many centers. The composition of trauma teams typically included airway and procedure doctors, nurses, and healthcare assistants. Trauma team leadership was predetermined in 59 % of the centers, with anesthesiologists/intensive care physicians often assuming this role. The study revealed gaps in trauma team education and governance, with a lack of specific training for trauma team leaders and low utilization of simulation-based training. These findings emphasize the need for improvements in trauma management education, governance, and the formalization of trauma teams. This study provides valuable insights that can guide discussions and interventions aimed at enhancing trauma care at both local and national levels in Italy.

Keywords: Education; Italy; Leadership; Trauma center; Trauma team.

MeSH terms

Cross-Sectional Studies
Emergency Medical Services*
Humans
Leadership
Patient Care Team
Simulation Training*
Trauma Centers