Trauma activation criteria vary from region to region if not trauma center to trauma center. Triage rules for major resuscitation in a trauma center allow for prioritization and judicious use of limited resources such as personnel, equipment, and services. The use of an overly inclusive may cause misuse limited hospital resources while limited trauma activation criteria may deny the best medical care to presenting trauma patients. Trauma activation criteria and guidelines in developing countries, particularly in the Middle East and Lebanon have not been previously described nor validated.

This retrospective study was conducted in the ED at the American University of Beirut Medical Center (AUBMC). AUBMC is the largest academic tertiary care center in Lebanon and is a major local and regional referral center. In 2012, the ED and trauma department formed a taskforce to implement a trauma response protocol for patients arriving with suspected major trauma. The protocol included introducing and training staff on trauma team activation criteria. The CDC prehospital field triage criteria were adopted with minor modifications.  

This study examines the performance of Emergency Department (ED) based TA criteria with respect to important clinical outcomes in a tertiary care center in Lebanon.

Variables that were collected included patient demographics, ED arrival method, trauma activation status, Emergency Severity Index (ESI) (ranging from 1 to 5, most to least urgent), injury details and Injury Severity Score (ISS), imaging modalities and surgical procedures, blood transfusion status, ED and hospital dispositions and cause of death. Selected outcomes variables were clinical (ISS and mortality) and resource utilization (Blood Product Transfusion (BPT), need for imaging (Computed Tomography: CT, X-ray), surgical procedures and Intensive Care Unit (ICU) admission).

This retrospective study was conducted in the ED at the American University of Beirut Medical Center (AUBMC). AUBMC is the largest academic tertiary care center in Lebanon and is a major local and regional referral center.

A chart review was conducted on patients of all age groups presenting with any type of trauma (coded in the ED electronic health records system as separate variables) who died in the ED or were hospitalized during a one-year period (July 1, 2016 – July 1, 2017). 

A chart review was conducted on patients of all age groups presenting with any type of trauma (coded in the ED electronic health records system as separate variables) who died in the ED or were hospitalized during a one-year period (July 1, 2016 – July 1, 2017).