Background Verbal prehospital reports on an injured patient’s condition are typically used by trauma centers to determine if a trauma team should be present in the emergency department prior to patient arrival (i. patients who needed the highest-level trauma team activation. Methods Ten local and national experts in emergency medicine emergency medical services and trauma were recruited to participate in a Modified Delphi survey process. The initial survey was populated based on outcomes that had been used in previously published literature on trauma team activation. The criterion standard definition for trauma team activation was processed iteratively based Rabbit polyclonal to LIN28. on survey responses until at least 80% agreement was achieved for each criterion. Results After five voting rounds a consensus-based definition for pediatric trauma team activation was developed. Twelve criteria were identified along with a corresponding time interval in which each criterion experienced to occur. The criteria include receiving specific medical procedures types interventional radiology advanced airway management thoracostomy blood products spinal injury Hydroxychloroquine Sulfate emergency cesarean section vasopressors burr hole or other procedure to relieve intracranial pressure pericardiocentesis thoracotomy and death in the emergency department. All expert panel users voted in all 5 voting rounds except 1 member missed rounds 1 and 2. Each criterion experienced greater than 80% agreement from the panel. Conclusion A criterion standard definition for the highest-level pediatric trauma team activation was developed. This criterion standard definition will advance trauma research by allowing investigators to determine the accuracy and effectiveness of highest-level pediatric trauma team activation protocols. Level of Evidence/Study type Qualitative published by the American College of Surgeons includes trauma team activation criteria.24 This text’s suggested protocol is primarily based on consensus opinion since there in limited literature available to assist in developing the protocol. There is a need to determine which trauma team activation protocol is best for identifying hurt pediatric patients who will benefit from the highest-level trauma team activation but the study of trauma team activation protocols requires researchers to use a criterion standard definition in order to calculate the accuracy sensitivity and specificity of the protocols. To date the criterion standard definitions used for trauma team activation research have not been consistent between research projects (Table 1). For example Sola et al. Hydroxychloroquine Sulfate assessed Hydroxychloroquine Sulfate activation protocol accuracy by determining whether the patient needed an operating room or pediatric rigorous Hydroxychloroquine Sulfate care unit7 while Dowd et al. assessed accuracy using specific forms of surgical procedures and specific resuscitative ED interventions.12 Without a consistent criterion standard definition for pediatric trauma team activation it is difficult to compare results across studies. The objective of this study was to define a consensus-based criterion standard definition for the highest-level pediatric trauma team activation. Table 1 Outcomes Identified after Critiquing the Previous Literature that were Included in the First Voting Round Survey METHODS This project used a altered Delphi technique to develop a list of criteria that would form the criterion standard definition for the highest-level pediatric trauma team activation. The Delphi technique is commonly utilized in the health sciences to synthesize knowledge through expert consensus. 25 Local and national experts in emergency medicine emergency medical services and trauma were recruited through email to participate in the expert panel (Table 2). Experts were identified using the principal investigators’ contacts and their respective contacts. Only individuals who experienced established careers in pediatric or general emergency medicine emergency medical services or pediatric surgery were considered for panel participation. TABLE 2 Local and National Experts Participation in the Delphi Process An initial Delphi survey was developed based on a review of the available literature on pediatric trauma team activations. The outcomes that were used for those analyses were reviewed and each of the end result criteria that were included in those studies was included in the first Delphi survey for this study (Table 1). Hydroxychloroquine Sulfate The surveys were distributed to each panel member through Survey Monkey?. The Hydroxychloroquine Sulfate panel users voted to keep remove or change each of the outcome.