From the Research
An E2 (Emergency Level 2) trauma case is a serious injury situation that requires prompt medical attention but is not immediately life-threatening, involving patients with significant injuries who are hemodynamically stable. These cases typically include injuries such as isolated long bone fractures, stable pelvic fractures, spinal injuries without neurological deficits, moderate burns, or blunt abdominal trauma without signs of significant bleeding. While these patients need urgent evaluation and treatment, they don't require the immediate full trauma team activation that Level 1 cases do. The trauma response for E2 cases often involves a modified team that can rapidly assess the patient, order appropriate imaging studies like CT scans or X-rays, and develop a treatment plan. These patients are monitored closely for any deterioration that might elevate their status to a higher level of emergency. Some key points to consider in E2 trauma cases include:
- The importance of early administration of tranexamic acid (TXA) in patients at risk for hemorrhage, as shown in studies such as 1 and 2, which demonstrated the safety and potential benefits of prehospital TXA administration.
- The potential synergy between prehospital blood transfusion and TXA administration, as suggested by study 3, which found an association between prehospital packed red blood cells (pRBC) + TXA and reduced 30-day mortality.
- The need for efficient allocation of hospital resources, with the E2 designation helping to ensure that the most critical cases receive immediate attention while still providing timely care to those with serious but stable injuries. Overall, the management of E2 trauma cases requires a balanced approach that takes into account the patient's stability, the severity of their injuries, and the potential benefits and risks of different treatment strategies, as informed by the latest evidence from studies such as 1, 2, and 3.