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Danish medical journal · Nov 2013
Visitation by physicians did not improve triage in trauma patients.
- Lars Andreas Holm Burén, Morten Daugaard, Jens Kjærgaard Rolighed Larsen, and Torben Krabbe Laustrup.
- Anæstesi- og operationsafdelingen, Regionshospitalet Viborg, Heibergs Allé 4, 8800 Viborg, Denmark. labure@rm.dk.
- Dan Med J. 2013 Nov 1;60(11):A4717.
IntroductionA formalized trauma response team is designed to optimize the quality and progress of patient care for severely injured patients in order to reduce mortality and morbidity. The goal of this study was to determine over- and undertriage and to evaluate if a physician-manned pre-hospital response (MD-EMS) would reduce overtriage. Overtriage was defined as the process of over-estimating the level of injury sustained by an individual.Material And MethodsThis was a retrospective study. All patients admitted with trauma team activation (TTA) (n = 1,468) during a four-year period (2007-2011) were included. Undertriage was estimated by assessing the fraction of major trauma patients (New Injury Severity Score (NISS) > 15) admitted to Viborg Regional Hospital in the project period without TTA.ResultsFor each year, overtriage was 88.3% (2007), 89.9% (2008), 92.8% (2009) and 88.2% (2010); an NISS > 15 was seen in a total of 149 patients. Undertriage was 0.39% (2007), 0.46% (2008), 0.51% (2009) and 1.10% (2010); an NISS > 15 was seen in a total of 21 patients who were not received by a trauma team. We observed no significant difference in the NISS (p = 0.19) or in over-/undertriage (p = 0.76 and p = 0.058) when comparing the years before with the years after the introduction of the MD-EMS response.ConclusionOur study shows a high degree of overtriage and a very low undertriage according to the currently accepted protocol guidelines. No effect was seen after the introduction of the MD-EMS.Fundingnot relevant.Trial RegistrationIn compliance with the Scientific Committees for the Region of Central Jutland, approval for our project was obtained prior to collecting data.
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