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European Journal of Trauma and Emergency Surgery

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Open Access 01-04-2022 | Triage | Original Article

Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study

Authors: Job F. Waalwijk, Robin D. Lokerman, Rogier van der Sluijs, Audrey A. A. Fiddelers, Luke P. H. Leenen, Mark van Heijl, Martijn Poeze, the Pre-hospital Trauma Triage Research Collaborative (PTTRC)

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

Abstract

Purpose

Priority-setting by dispatch centers and Emergency Medical Services professionals has a major impact on pre-hospital triage and times of trauma patients. Patients requiring specialized care benefit from expedited transport to higher-level trauma centers, while transportation of these patients to lower-level trauma centers is associated with higher mortality rates. This study aims to evaluate the accuracy of priority-setting by dispatch centers and Emergency Medical Services professionals.

Methods

This observational study included trauma patients transported from the scene of injury to a trauma center. Priority-setting was evaluated in terms of the proportion of patients requiring specialized trauma care assigned with the highest priority (i.e., sensitivity), undertriage, and overtriage. Patients in need of specialized care were defined by a composite resource-based endpoint. An Injury Severity Score ≥ 16 served as a secondary reference standard.

Results

Between January 2015 and December 2017, records of 114,459 trauma patients were collected, of which 3327 (2.9%) patients were in need of specialized care according to the primary reference standard. Dispatch centers and Emergency Medical Services professionals assigned 83.8% and 74.5% of these patients with the highest priority, respectively. Undertriage rates ranged between 22.7 and 65.5% in the different prioritization subgroups. There were differences between dispatch and transport priorities in 17.7% of the patients.

Conclusion

The majority of patients that required specialized care were assigned with the highest priority by the dispatch centers and Emergency Medical Services professionals. Highly accurate priority criteria could improve the quality of pre-hospital triage.

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Title: Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study
Authors: Job F. Waalwijk
Robin D. Lokerman
Rogier van der Sluijs
Audrey A. A. Fiddelers
Luke P. H. Leenen
Mark van Heijl
Martijn Poeze
the Pre-hospital Trauma Triage Research Collaborative (PTTRC)
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keyword: Triage
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01685-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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