Impact of Minimal Injuries on a Level I Trauma Center.
Publication/Presentation Date
9-1-1992
Abstract
Overtriage (i.e.; transport of patients with minimal injuries to a trauma center) has been accepted as necessary to avoid missing clinically significant injuries. We reviewed our experience with 344 patients (ISS less than or equal to 4) who were admitted to a level I trauma center during a 2-year period. The trauma team was activated for 209 patients (TA), and emergency department referrals accounted for 135 (ED). One hundred seventy-three patients (TA = 64%, ED = 36%) met American College of Surgeons' Committee on Trauma (ACSCOT) field triage criteria (FTC). Mechanism of injury, especially ejection from a motor vehicle, was the most frequently utilized FTC indicator. We found no differences between the TA and ED groups relative to Trauma Score, Glasgow Coma Scale score, Injury Severity Score, length of stay, or ICU days. Mean total costs were higher for the TA group than for the ED group. The TA group had a higher nursing acuity level than the ED group. Compliance with FTC yields an inherent overtriage of minimally injured patients; however, noncompliance with FTC compounds the overtriage rate. Failure to comply with FTC is costly, labor intensive, and may represent misuse of the trauma system. We propose continual re-education of prehospital personnel, increased responsibility of all hospitals in the trauma center catchment area, and protocols for "downstaging" trauma resuscitation in minimally injured patients.
Volume
33
Issue
3
First Page
408
Last Page
412
ISSN
0022-5282
Published In/Presented At
Hoff, W. S., Tinkoff, G. H., Lucke, J. F., & Lehr, S. (1992). Impact of minimal injuries on a level I trauma center. The Journal Of Trauma, 33(3), 408-412.
Disciplines
Medicine and Health Sciences | Other Medical Specialties | Surgery | Trauma
PubMedID
1404510
Department(s)
Department of Surgery
Document Type
Article