TY - JOUR
T1 - Is a maximum Revised Trauma Score a safe triage tool for Helicopter Emergency Medical Services cancellations?
AU - Giannakopoulos, Georgios F.
AU - Saltzherr, Teun Peter
AU - Lubbers, Wouter D.
AU - Christiaans, Herman M. T.
AU - van Exter, Pieternel
AU - de Lange-de Klerk, Elly S. M.
AU - Bloemers, Frank W.
AU - Zuidema, Wietse P.
AU - Goslings, J. Carel
AU - Bakker, Fred C.
PY - 2011
Y1 - 2011
N2 - Introduction The Revised Trauma Score is used worldwide in the prehospital setting and provides a snapshot of patient's physiological state. Several studies have shown that the reliability of the RTS is high in trauma outcomes. In the Netherlands, Helicopter Emergency Medical Services (HEMS) are mostly used for delivery of specialized trauma teams on-scene and occasionally for patient transportation. In our trauma system, the Emergency Medical Services crew performs triage after arrival on-scene and cancels the HEMS-dispatch if deemed unnecessary. In this study we assessed the ability of a maximum on-scene Revised Trauma Score (RTS = 12) to be used as a triage tool for HEMS cancellation. Methods All patients with a maximum on-scene RTS after blunt trauma (with or without receiving HEMS care) who were presented in the trauma resuscitation room of two Level-1 trauma centers during a period of 6 months, were included. Information concerning prehospital and in-hospital vital parameters, severity and localization of the injuries, and the in-hospital course were analyzed. Major trauma patients were classified using the following parameters: Injury Severity Score of at least 16, emergency intervention, Intensive Care Unit admission, and in-hospital death. Results Four-hundred and forty blunt trauma patients having a maximum RTS were included between 1 July and 31 December 2006. Eighty patients received on-scene HEMS care. Almost 16% of the total population concerned major trauma patients, of which only 25 (36%) received HEMS care. In 17 patients (3.9%), the RTS deteriorated during transportation. Major trauma patients sustained more injuries to the chest, abdomen, and lower extremities. Conclusion The RTS alone is not a reliable triage tool for HEMS cancellations in our trauma system and will lead to a considerable rate of undertriage with one in every six cancellations being incorrect. Other criteria based on patient's vital signs, combined with anatomical and mechanism of injury parameters should be developed to safely minimize triage errors. European Journal of Emergency Medicine 18: 197-201 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
AB - Introduction The Revised Trauma Score is used worldwide in the prehospital setting and provides a snapshot of patient's physiological state. Several studies have shown that the reliability of the RTS is high in trauma outcomes. In the Netherlands, Helicopter Emergency Medical Services (HEMS) are mostly used for delivery of specialized trauma teams on-scene and occasionally for patient transportation. In our trauma system, the Emergency Medical Services crew performs triage after arrival on-scene and cancels the HEMS-dispatch if deemed unnecessary. In this study we assessed the ability of a maximum on-scene Revised Trauma Score (RTS = 12) to be used as a triage tool for HEMS cancellation. Methods All patients with a maximum on-scene RTS after blunt trauma (with or without receiving HEMS care) who were presented in the trauma resuscitation room of two Level-1 trauma centers during a period of 6 months, were included. Information concerning prehospital and in-hospital vital parameters, severity and localization of the injuries, and the in-hospital course were analyzed. Major trauma patients were classified using the following parameters: Injury Severity Score of at least 16, emergency intervention, Intensive Care Unit admission, and in-hospital death. Results Four-hundred and forty blunt trauma patients having a maximum RTS were included between 1 July and 31 December 2006. Eighty patients received on-scene HEMS care. Almost 16% of the total population concerned major trauma patients, of which only 25 (36%) received HEMS care. In 17 patients (3.9%), the RTS deteriorated during transportation. Major trauma patients sustained more injuries to the chest, abdomen, and lower extremities. Conclusion The RTS alone is not a reliable triage tool for HEMS cancellations in our trauma system and will lead to a considerable rate of undertriage with one in every six cancellations being incorrect. Other criteria based on patient's vital signs, combined with anatomical and mechanism of injury parameters should be developed to safely minimize triage errors. European Journal of Emergency Medicine 18: 197-201 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
U2 - https://doi.org/10.1097/MEJ.0b013e328344912e
DO - https://doi.org/10.1097/MEJ.0b013e328344912e
M3 - Article
C2 - 21326101
SN - 0969-9546
VL - 18
SP - 197
EP - 201
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 4
ER -