TY - JOUR PY - 2019// TI - Accuracy of pre-hospital trauma notification calls JO - American journal of emergency medicine A1 - Clarke, Lavonne A. A1 - James, Melissa K. A1 - Simpson, Rose M. A1 - Noto, Anthony J. A1 - Sclair, Joshua R. A1 - Doughlin, Geoffrey K. A1 - Lee, Shi-Wen SP - 620 EP - 626 VL - 37 IS - 4 N2 - STUDY OBJECTIVE: The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage.

METHODS: This study was conducted at a level-1 trauma center over a two-year period. Data was collected from pre-notification forms on trauma activations that arrived to the emergency department via ambulance. Trauma activations with pre-notification were compared to those without notification and pre-notification forms were assessed for accuracy and completeness.

RESULTS: A total of 2186 trauma activations were included in the study, 1572 (71.9%) had pre-notifications, 614 (28.1%) did not and were initially under-triaged. Pre-notification forms were completed for 1505 (95.7%) patients, of which EMS provided incomplete/inaccurate information for 1204 (80%) patients and complete/accurate information for 301 (20%) patients. Missing GCS/AVPU score (1099, 91.3%), wrong age (357, 29.6%), and missing vitals (303, 25.2%) were the main problems. Missing/wrong information resulted in trauma tier over-activation in 25 (2.1%) patients and under-activation in 20 (1.7%) patients. Under-triaged patients were predominantly male (18, 90%), sustained a fall (9, 45%), transported by BLS EMS teams (12, 60%), and arrived on a weekday (13, 65%) during the time period of 11 pm-7 am (9, 45%). A total of 13 (65%) required emergent intubation, 2 (10%) required massive transfusion activation, 7 (35%) were admitted to ICU, 3 (15%) were admitted directly to the OR, and 1 (15%) died.

CONCLUSION: EMS crews frequently provide inaccurate pre-hospital information or do not provide any pre-hospital notification at all, which results in over/under triage of trauma patients.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

LA - en SN - 0735-6757 UR - http://dx.doi.org/10.1016/j.ajem.2018.06.058 ID - ref1 ER -