Protocol-driven trauma resuscitation: survey of UK practice

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.