BACKGROUND: Pre-hospital triage protocols are an important component in the treatment of injured patients. The aim was to determine the level of, and factors associated with, adherence to the pre-hospital trauma triage criteria for urban patients transported in New South Wales, Australia. METHOD: This retrospective study included patients injured in urban areas who were transported by road for the treatment of traumatic injuries in the period 1 July 2006 to 30 June 2007. RESULTS: Of the 57,775 transported to hospital due to traumatic injury, 9344 (16%) met one or more of the pre-hospital triage criteria. Of these, 74% were transported to a protocol adherent major or regional trauma centre. Adherence rates differed by triage criteria met and was lowest for patients meeting physiologic-only criteria (63.5%) and highest for patients meeting all three triage criteria of physiology, mechanism and injury (85.4%). Female gender, increasing patient age, patients classified as having had a fall, the qualification level of treating officer and patients transported between midday to 18:00 (relative to those transported between midnight to 06:00) were factors associated with significantly lower levels of protocol adherence with respect to hospital destination. Minimal time differences were evident between patients transported to protocol adherent and non-adherent destinations. CONCLUSION: Based on the post hoc evaluation of triage status, adherence to the triage protocol was 74%. Analysis of patient destinations for protocol non-adherence appears to indicate that paramedic interpretation and discretion played a role in determining hospital choice. There was a marginal time difference between those transported to protocol adherent and non-adherent destinations. Future research needs to determine whether deviations from protocol are associated with differential mortality. Crown
BACKGROUND: Pre-hospital triage protocols are an important component in the treatment of injured patients. The aim was to determine the level of, and factors associated with, adherence to the pre-hospital trauma triage criteria for urban patients transported in New South Wales, Australia. METHOD: This retrospective study included patients injured in urban areas who were transported by road for the treatment of traumatic injuries in the period 1 July 2006 to 30 June 2007. RESULTS: Of the 57,775 transported to hospital due to traumatic injury, 9344 (16%) met one or more of the pre-hospital triage criteria. Of these, 74% were transported to a protocol adherent major or regional trauma centre. Adherence rates differed by triage criteria met and was lowest for patients meeting physiologic-only criteria (63.5%) and highest for patients meeting all three triage criteria of physiology, mechanism and injury (85.4%). Female gender, increasing patient age, patients classified as having had a fall, the qualification level of treating officer and patients transported between midday to 18:00 (relative to those transported between midnight to 06:00) were factors associated with significantly lower levels of protocol adherence with respect to hospital destination. Minimal time differences were evident between patients transported to protocol adherent and non-adherent destinations. CONCLUSION: Based on the post hoc evaluation of triage status, adherence to the triage protocol was 74%. Analysis of patient destinations for protocol non-adherence appears to indicate that paramedic interpretation and discretion played a role in determining hospital choice. There was a marginal time difference between those transported to protocol adherent and non-adherent destinations. Future research needs to determine whether deviations from protocol are associated with differential mortality. Crown
Authors: Brooke L Namboodri; Tony Rosen; Joseph A Dayaa; Jason J Bischof; Nadeem Ramadan; Mehul D Patel; Joseph Grover; Jane H Brice; Timothy F Platts-Mills Journal: J Am Geriatr Soc Date: 2018-03-22 Impact factor: 5.562
Authors: Eveline A J van Rein; Said Sadiqi; Koen W W Lansink; Rob A Lichtveld; Risco van Vliet; F Cumhur Oner; Luke P H Leenen; Mark van Heijl Journal: Eur J Trauma Emerg Surg Date: 2018-09-20 Impact factor: 3.693
Authors: Remco H A Ebben; Lilian C M Vloet; Pierre M van Grunsven; Wim Breeman; Ben Goosselink; Rob A Lichtveld; Joke A J Mintjes-De Groot; Theo van Achterberg Journal: Eur J Emerg Med Date: 2015-06 Impact factor: 2.799