Citation

Fitzharris M, Stevenson MR, Middleton P, Sinclair G. Injury 2012; 43(9): 1368-1376.

Affiliation

Injury Outcomes Research Unit & Accident Research Centre, Monash Injury Research Institute, Monash University, Melbourne, Australia; Critical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australia.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.injury.2011.10.019

PMID

22062495

Abstract

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.

Language: en