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Use of 911 for Rapid Re-Triage of Critical Trauma Patients

Published online by Cambridge University Press:  14 July 2020

Jake Toy Open the ORCID record for Jake Toy [Opens in a new window] ,
Clayton Kazan ,
Marianne Gausche-Hill  and
Nichole Bosson
Jake Toy*
Affiliation:
Harbor UCLA Medical Center, Department of Emergency Medicine, Torrance, CaliforniaUSA; The Lundquist Institute, Torrance, CaliforniaUSA
Clayton Kazan
Affiliation:
Los Angeles County EMS Agency, Santa Fe Springs, CaliforniaUSA
Marianne Gausche-Hill
Affiliation:
Harbor UCLA Medical Center, Department of Emergency Medicine, Torrance, CaliforniaUSA; The Lundquist Institute, Torrance, CaliforniaUSA Los Angeles County EMS Agency, Santa Fe Springs, CaliforniaUSA
Nichole Bosson
Affiliation:
Harbor UCLA Medical Center, Department of Emergency Medicine, Torrance, CaliforniaUSA; The Lundquist Institute, Torrance, CaliforniaUSA Los Angeles County EMS Agency, Santa Fe Springs, CaliforniaUSA David Geffen School of Medicine at UCLA, Los Angeles, CaliforniaUSA
*
Correspondence: Jake Toy, DO, Department of Emergency Medicine, Harbor-UCLA Medical Center, 1000 W Carson St, Box 21, Building D9, Torrance, California90509, USA, E-mail: [email protected]
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Abstract

Objectives:

The objective of this study was to evaluate the effectiveness of a 911 trauma re-triage protocol implemented at a new community hospital in a region with a high volume of trauma and frequent transports by private vehicle.

Methods:

This retrospective cohort study included all trauma patients ≥15 years old transferred via 911 trauma re-triage from a new community hospital over a 10-month period from August 2015 through April 2016. Criteria for 911 trauma re-triage were developed with input from local Emergency Medical Services (EMS) and trauma experts. An educational module, along with the criteria and implementation steps, was distributed to the emergency department (ED) personnel at the community hospital. Data were abstracted from the regional trauma registry, and the EMS patient care records were reviewed. Primary outcomes were: (1) median total transport time; and (2) proportion of patients who met the 911 re-triage criteria.

Results:

During the study period, 32 patients with traumatic injuries were transferred via 911 re-triage to the closest trauma center (TC). The median age of patients was 31 years (IQR 24-45 years) with 78% male and 66% suffering from a penetrating mechanism. The median prehospital provider scene time was 10 minutes (IQR 8-12 minutes) and transport time was seven minutes (IQR 6-9 minutes). Median total transport time was 17 minutes (IQR 15-20 minutes). Seventeen patients (53%) met 911 re-triage criteria as determined by study investigators. The most common criteria met was “penetrating injury to the head, neck, or torso” in 14 cases.

Conclusion:

This study demonstrated that 911 re-triage was a feasible strategy to expeditiously transfer critical trauma patients to a TC within a mature trauma system in an urban-suburban setting with a median total transport time of 17 minutes.

Keywords

inter-facility transferpatient transferre-triagetraumatriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 5 , October 2020 , pp. 488 - 494
Copyright
© World Association for Disaster and Emergency Medicine 2020

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