Abstract
The ultimate goal of trauma systems is to match the needs of the injured patient to the closest hospital with the capability of providing definitive care in the most appropriate timeframe. The purpose of this study is to analyze the accuracy of prehospital trauma scoring by EMS providers based on OPTTG in order to identify inaccuracies and improve patient care. Our hypothesis is that at some rate EMS inaccurately triage trauma patients when compared to state guidelines.
A retrospective chart review compared Comanche County Memorial Hospital (CCMH) EMS run reports to OPTTG. Data was extracted from EMS reports January 1, 2017 through December 31, 2019 to determine priority of trauma triage. Two physicians performed chart review and data entry to decrease uncertainty and bias.4 Data was analyzed using Spearman correlation. Kappa scoring was used to decrease chance and increase validity.
Preliminary data review consisted of 2,180 trauma charts that included both a trauma score reported by EMS and a trauma score calculated after review of emergency department records. The most common inaccuracy was undertriage of priority 1 and 2 trauma patients. Failure to recognize comorbidities of age, concurrent anticoagulation use, altered mental status and hemodynamic compromise were the most common causes of inaccuracy.
Overall, 25.1% of patients were undertriaged, which is greater than the acceptable rate (5%) as published by the American College of Surgeons Committee on Trauma (ACSCOT).1 We believe this can be improved with further education of EMS providers to avoid undertriage of trauma, particularly priority 1 and 2 trauma patients.
A retrospective chart review compared Comanche County Memorial Hospital (CCMH) EMS run reports to OPTTG. Data was extracted from EMS reports January 1, 2017 through December 31, 2019 to determine priority of trauma triage. Two physicians performed chart review and data entry to decrease uncertainty and bias.4 Data was analyzed using Spearman correlation. Kappa scoring was used to decrease chance and increase validity.
Preliminary data review consisted of 2,180 trauma charts that included both a trauma score reported by EMS and a trauma score calculated after review of emergency department records. The most common inaccuracy was undertriage of priority 1 and 2 trauma patients. Failure to recognize comorbidities of age, concurrent anticoagulation use, altered mental status and hemodynamic compromise were the most common causes of inaccuracy.
Overall, 25.1% of patients were undertriaged, which is greater than the acceptable rate (5%) as published by the American College of Surgeons Committee on Trauma (ACSCOT).1 We believe this can be improved with further education of EMS providers to avoid undertriage of trauma, particularly priority 1 and 2 trauma patients.
| Original language | American English |
|---|---|
| State | Published - 17 May 2023 |
| Event | 6th Annual Resident/Fellow Quality Improvement and Patient Safety Symposium 2023 - Oklahoam State University Center for Health Sciences , Tulsa, United States Duration: 17 May 2023 → 17 May 2023 https://medicine.okstate.edu/gme/quality-symposium/2023-quality-symposium.html |
Conference
| Conference | 6th Annual Resident/Fellow Quality Improvement and Patient Safety Symposium 2023 |
|---|---|
| Country/Territory | United States |
| City | Tulsa |
| Period | 17/05/23 → 17/05/23 |
| Internet address |