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Guidelines for Field Triage of Injured Patients: Recommendations of the National Expert Panel on Field Triage
  • Language: English
  • Tags: Triage Systems
Description

In the United States, injury is the leading cause of death for persons aged 1-44 years. In 2008, approximately 30 million injuries were serious enough to require the injured person to visit a hospital emergency department (ED); 5.4 million (18%) of these injured patients were transported by Emergency Medical Services (EMS). On arrival at the scene of an injury, the EMS provider must determine the severity of injury, initiate management of the patient's injuries, and decide the most appropriate destination hospital for the individual patient. These destination decisions are made through a process known as "field triage," which involves an assessment not only of the physiology and anatomy of injury but also of the mechanism of the injury and special patient and system considerations. Since 1986, the American College of Surgeons Committee on Trauma (ACS-COT) has provided guidance for the field triage process through its "Field Triage Decision Scheme." This guidance was updated with each version of the decision scheme (published in 1986, 1990, 1993, and 1999). In 2005, CDC, with financial support from the National Highway Traffic Safety Administration, collaborated with ACS-COT to convene the initial meetings of the National Expert Panel on Field Triage (the Panel) to revise the decision scheme; the revised version was published in 2006 by ACS-COT (American College of Surgeons. Resources for the optimal care of the injured patient: 2006. Chicago, IL: American College of Surgeons; 2006). In 2009, CDC published a detailed description of the scientific rationale for revising the field triage criteria (CDC. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage. MMWR 2009;58[No. RR-1]). In 2011, CDC reconvened the Panel to review the 2006 Guidelines in the context of recently published literature, assess the experiences of states and local communities working to implement the Guidelines, and recommend any needed changes or modifications to the Guidelines. This report describes the dissemination and impact of the 2006 Guidelines; outlines the methodology used by the Panel for its 2011 review; explains the revisions and modifications to the physiologic, anatomic, mechanism-of-injury, and special considerations criteria; updates the schematic of the 2006 Guidelines; and provides the rationale used by the Panel for these changes. This report is intended to help prehospital-care providers in their daily duties recognize individual injured patients who are most likely to benefit from specialized trauma center resources and is not intended as a mass casualty or disaster triage tool. The Panel anticipates a review of these Guidelines approximately every 5 years.

Effectiveness of Prehospital Trauma Triage Systems in Selecting Severely Injured Patients: Is Comparative Analysis Possible?
  • Language: English
  • Tags: Triage Systems
Description

In an optimal trauma system, prehospital trauma triage ensures transport of the right patient to the right hospital. Incorrect triage results in undertriage and overtriage. The aim of this systematic review is to evaluate and compare prehospital trauma triage system quality worldwide and determine effectiveness in terms of undertriage and overtriage for trauma patients.

Analysis of Emergency Medical Services Triage and Dispatch Errors by Registered Nurses in Italy
  • Language: English
  • Tags: Gaps and Challenges Emergency Call Center
Description

The major elements of an effective emergency medical services (EMS) system include a single telephone access number, accurate assessment of the urgency of the health problem, and timely dispatch of appropriate personnel and equipment. In Italy, EMS calls are managed by emergency operations centers by registered nurses who have received specialized education in this function. The nurses determine the criticality of the situations and assign an EMS response priority level identified by a color code, ranging from red (very critical) to green (not critical). At times, the severity of a situation may be underestimated, resulting in assignment of a lower EMS response priority and the potential for patient death (code black). The purpose of this study was to analyze factors associated with registered nurse under-triage of EMS calls subsequently found to be associated with deaths, termed "green-black code" cases.

Differentiation of Confirmed Major Trauma Patients and Potential Major Trauma Patients Using Pre-Hospital Trauma Triage Criteria
  • Language: English
  • Tags: Triage Systems
Description

There is a paucity of literature comparing trauma patients who meet pre-hospital trauma triage guidelines ('potential major trauma') with trauma patients who are identified as 'confirmed major trauma patients' at hospital discharge. This type of epidemiological surveillance is critical to continuous performance monitoring of mature trauma care systems. The current study aimed to determine if the current trauma triage criteria resulted in under/over-triage and whether the triage criteria were being adhered to.

Recommendations: Prehospital Emergency Medical Services (EMS) COVID-19
  • Language: English
  • Tags: EMS The Scene
Description

This document provides general guidance for Emergency Medical Service (EMS) preparedness and response to COVID19. At a local and state level, regulations and resource configurations may vary. In addition to these recommendations, EMS agencies should consult with local stakeholders.

Comparing emergency medical service systems—A project of the European Emergency Data (EED) Project
  • Language: English
  • Tags: EMS The Scene
Description

The aim of this prospective study was the comparison of four emergency medical service (EMS) systems—emergency physician (EP) and paramedic (PM) based—and the impact of advanced live support (ALS) on patients status in preclinical care.

Can paramedics using guidelines accurately triage patients?
  • Language: English
  • Tags: EMS Medical Treatment Triage Systems
Description

This report presents an information on a study carried out to determine whether paramedics, using written guidelines, can accurately triage patients in the field.

Paramedics
  • Language: English
  • Tags: EMS EMS Work Force
Description

Health and Care Professions Council’s standards of proficiency for paramedics.

The quality of a newly developed infant chest compression method applied by paramedics: a randomised crossover manikin trial
  • Language: English
  • Tags: EMS Triage Systems
Description

This document presents information on the randomised crossover manikin trial which aims to assess the CC quality during simulated resuscitation in infants performed by paramedics.

Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial
  • Language: English
  • Tags: EMS Triage Systems
Description

This document shows whether the introduction of LUCAS-2 mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest.

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