• Der Anaesthesist · Dec 2013

    [Reliability of emergency medical field triage : Exemplified by traffic accident victims.]

    • M Helm, L Lampl, and T Unger.
    • Klinik für Anästhesiologie & Intensivmedizin - Sektion Notfallmedizin/Luftrettungszentrum "Christoph 22", Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland, matthias.helm@extern.uni-ulm.de.
    • Anaesthesist. 2013 Dec 1;62(12):973-80.

    BackgroundTrauma is the leading cause of death in the patient group under 40 years of age. Within the prehospital management of seriously injured trauma victims the accuracy of the field triage by emergency physicians is of utmost importance.ObjectiveThe aim of this study was to determine the accuracy of prehospital emergency physician field triage in road traffic accident victims.Material And MethodsThe study involved a retrospective analysis and comparison of prehospital and inhospital trauma records of road traffic accident victims treated by a Helicopter Emergency Medical Service (HEMS) team and transferred to a level I trauma centre. A comparison of prehospital and inhospital diagnostic findings was carried out according to an anatomical score (AIS).ResultsIncluded in the analysis were 479 patients with a mean age of 37.0 ± 18.2 years, males 65.8 %, mean injury severity score (ISS) 15.5 ± 13.5, ISS > 16 in 41,1 % and mortality 7.3 %. The leading causes of injury were motor vehicle accidents (56.2 %), followed by motorcycle (24.0 %) and bicycle accidents (11.6 %) as well as truck accidents (4.0 %) and pedestrian accidents (4.2 %). The most common body regions injured (AIS ≥ 3) were the chest (37 %), head (25.1 %) and lower extremities (16.7 %). A correct prehospital field triage by emergency physicians was found for injuries with an AIS ≥ 3 of the head 77 %, chest 69 %, abdomen 51 %, pelvis 49 %, extremities 70 %, neck/cervical spine 67 % and thoracic/lumbar spine 70 %. Overlooked injuries in the prehospital setting (AIS ≥ 3) comprised predominantly injuries of the trunk (chest 12.6 %, abdomen 16.9 % and pelvis 15 %). Overlooked injuries were found significantly less for the head in patients with a Glasgow Coma Score ≤ 8 on arrival at the scene (5.4 % versus 19 %, p = 0.015), for the chest in patients with a S(p)O(2) ≤ 96 % on arrival at the scene (18.1 % versus 35.5 %, p = 0.004) and for the abdomen in patients with a systolic blood pressure < 90 mmHg on arrival at the scene (28.6 % versus 52.5 %, p = 0.025).ConclusionAccurate field triage in seriously injured road accident victims, even by trained physicians, is difficult. This pertains especially to injuries to the abdomen and the pelvis. For the field triage a combination of anatomical and physiological criteria as well as the mechanism of injury should be used to increase accuracy.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.