1. Accuracy of Prehospital Triage of Adult Patients With Traumatic Injuries Following Implementation of a Trauma Triage Intervention.
- Author
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Lokerman, R.D., Rein, E.A.J. van, Waalwijk, J.F., Sluijs, R. van der, Houwert, R.M., Lansink, K.W.W, Edwards, M.J.R., Vliet, R., Verhagen, T.F., Diets-Veenendaal, N., Leenen, L.P.H., Heijl, M. van, Lokerman, R.D., Rein, E.A.J. van, Waalwijk, J.F., Sluijs, R. van der, Houwert, R.M., Lansink, K.W.W, Edwards, M.J.R., Vliet, R., Verhagen, T.F., Diets-Veenendaal, N., Leenen, L.P.H., and Heijl, M. van
- Abstract
Item does not contain fulltext, IMPORTANCE: Adequate prehospital triage is pivotal to enable optimal care in inclusive trauma systems and reduce avoidable mortality, lifelong disabilities, and costs. A model has been developed to improve the prehospital allocation of patients with traumatic injuries and was incorporated in an application (app) to be implemented in prehospital practice. OBJECTIVE: To evaluate the association between the implementation of a trauma triage (TT) intervention with an app and prehospital mistriage among adult trauma patients. DESIGN, SETTING, AND PARTICIPANTS: This population-based, prospective quality improvement study was conducted in 3 of the 11 Dutch trauma regions (27.3%), with full coverage of the corresponding emergency medical services (EMS) regions participating in this study. Participants included adult patients (age ≥16 years) with traumatic injuries who were transported by ambulance between February 1, 2015, and October 31, 2019, from the scene of injury to any emergency department in the participating trauma regions. Data were analyzed between July 2020 and June 2021. EXPOSURES: Implementation of the TT app and the awareness of need for adequate triage created by its implementation (ie, the TT intervention). MAIN OUTCOMES AND MEASURES: The primary outcome was prehospital mistriage, evaluated in terms of undertriage and overtriage. Undertriage was defined as the proportion of patients with an Injury Severity Score (ISS) of 16 or greater who were initially transported to a lower-level trauma center (designated to treat patients who are mildly and moderately injured) and overtriage as the proportion of patients with an ISS of less than 16 who were initially transported to a higher-level trauma center (designated to treat patients who are severely injured). RESULTS: A total of 80 738 patients were included (40 427 [50.1%] before and 40 311 [49.9%] after implementation of the intervention), with a median (IQR) age of 63.2 (40.0-79.7) years and 40 132 (49.7%) male
- Published
- 2023