|
Citation
|
James MK, Clarke LA, Simpson RM, Noto AJ, Sclair JR, Doughlin GK, Lee SW. Am. J. Emerg. Med. 2019; 37(4): 620-626. |
|
Abstract
|
STUDY OBJECTIVE: The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage.
METHODS: This study was conducted at a level-1 trauma center over a two-year period. Data was collected from pre-notification forms on trauma activations that arrived to the emergency department via ambulance. Trauma activations with pre-notification were compared to those without notification and pre-notification forms were assessed for accuracy and completeness.
RESULTS: A total of 2186 trauma activations were included in the study, 1572 (71.9%) had pre-notifications, 614 (28.1%) did not and were initially under-triaged. Pre-notification forms were completed for 1505 (95.7%) patients, of which EMS provided incomplete/inaccurate information for 1204 (80%) patients and complete/accurate information for 301 (20%) patients. Missing GCS/AVPU score (1099, 91.3%), wrong age (357, 29.6%), and missing vitals (303, 25.2%) were the main problems. Missing/wrong information resulted in trauma tier over-activation in 25 (2.1%) patients and under-activation in 20 (1.7%) patients. Under-triaged patients were predominantly male (18, 90%), sustained a fall (9, 45%), transported by BLS EMS teams (12, 60%), and arrived on a weekday (13, 65%) during the time period of 11 pm-7 am (9, 45%). A total of 13 (65%) required emergent intubation, 2 (10%) required massive transfusion activation, 7 (35%) were admitted to ICU, 3 (15%) were admitted directly to the OR, and 1 (15%) died.
CONCLUSION: EMS crews frequently provide inaccurate pre-hospital information or do not provide any pre-hospital notification at all, which results in over/under triage of trauma patients.
Copyright © 2018 Elsevier Inc. All rights reserved.
Language: en |