Citation

Macken L, Manovel A. Emerg. Med. Australas. 2005; 17(2): 137-142.

Affiliation

Department of Emergency Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia. Lmacken@doh.health.nsw.gov.au

Copyright

(Copyright © 2005, Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine, Publisher John Wiley and Sons)

DOI

10.1111/j.1742-6723.2005.00705.x

PMID

15796728

Abstract

OBJECTIVE: The New South Wales (NSW) Health Department and the Ambulance Service of NSW introduced a trauma bypass system in Sydney on 29 March 1992. This study aims to review the outcomes of trauma bypass patients brought to St George Hospital, a major trauma service in south-eastern Sydney, and to assess the performance of the current prehospital trauma triage protocol. METHODS: The St George Hospital Department of Trauma Services prospectively collected data on all trauma bypass patients for the 8-year period from 29 March 1992 to 29 March 2000. RESULTS: A total of 1990 patients were brought to hospital on trauma bypass. The average age was 32 years, 70% were men and 66% were from road traffic accidents. The positive predictive value of the prehospital triage tool for serious injury (Injury Severity Score [ISS] > 15) was 18.6% (95% CI 16.9-20.4). This is well below the benchmark previously established by the NSW Health Department Trauma System Advisory Committee. For all trauma bypass patients, 33.8% (95% CI 31.7-35.9) were discharged home from the ED. The overall death rate was 2.5% (95% CI 1.9-3.3). CONCLUSIONS: According to the proposed benchmark, current prehospital trauma triage guidelines are underperforming. This suggests that a review of the benchmarks of current local trauma systems and of the trauma triage tool is required.

Language: en