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Determination of the triage skill and knowledge levels of prehospital emergency medical staff: A cross-sectional study

Awwad K, Ng YG, Lee K, Lim PY, Rawajbeh B

Int Emerg Nurs, 2022 09;64:101203.
PMID: 35930980 DOI: 10.1016/j.ienj.2022.101203
Matched MeSH terms: Triage*
Triage: A Global Perspective

Peta D, Day A, Lugari WS, Gorman V, Ahayalimudin N, Pajo VMT

J Emerg Nurs, 2023 Nov;49(6):814-825.
PMID: 37925222 DOI: 10.1016/j.jen.2023.08.004

Triage is a process by which patients are assessed, classified, and sorted based on their presenting complaint and clinical urgency, providing assurance for timely access to emergency care. The goal is to get the right person to the right place, in the right amount of time, for the right reason, and within the context of resource availability. In many countries, a standardized triage system, underpinned through the use of guidelines, is used to provide clinicians with support and guidance. Triage is a globally adopted principle, and although triage guidelines are used in many countries, no single system has been internationally adopted. This paper discusses the importance of how triage process standardization improves patient care, resource management, and benchmarking at local, national, and international levels by applying 5 internationally recognized triage systems to fictional case studies. Evaluation of similarities and differences in severity scores, with a gap analysis, occurs.

Matched MeSH terms: Triage*
Modified physiologic criteria for the field triage scheme: Efficacy of major trauma recognition in different age groups in Asia

Chien YC, Ko YC, Chiang WC, Sun JT, Shin SD, Tanaka H, et al.

Am J Emerg Med, 2024 Mar;77:147-153.
PMID: 38150984 DOI: 10.1016/j.ajem.2023.12.011

BACKGROUND: Major trauma is a leading cause of unexpected death globally, with increasing age-adjusted death rates for unintentional injuries. Field triage schemes (FTSs) assist emergency medical technicians in identifying appropriate medical care facilities for patients. While full FTSs may improve sensitivity, step-by-step field triage is time-consuming. A simplified FTS (sFTS) that uses only physiological and anatomical criteria may offer a more rapid decision-making process. However, evidence for this approach is limited, and its performance in identifying all age groups requiring trauma center resources in Asia remains unclear.
METHODS: We conducted a multinational retrospective cohort study involving adult trauma patients admitted to emergency departments in the included countries from 2016 to 2020. Prehospital and hospital data were reviewed from the Pan-Asia Trauma Outcomes Study database. Patients aged ≥18 years transported by emergency medical services were included. Patients lacking data regarding age, sex, physiological criteria, or injury severity scores were excluded. We examined the performance of sFTS in all age groups and fine-tuned physiological criteria to improve sFTS performance in identifying high-risk trauma patients in different age groups.
RESULTS: The sensitivity and specificity of the physiological and anatomical criteria for identifying major trauma (injury severity score ≥ 16) were 80.6% and 58.8%, respectively. The modified sFTS showed increased sensitivity and decreased specificity, with more pronounced changes in the young age group. Adding the shock index further increased sensitivity in both age groups.
CONCLUSIONS: sFTS using only physiological and anatomical criteria is suboptimal for Asian adult patients with trauma of all age groups. Adjusting the physiological criteria and adding a shock index as a triage tool can improve the sensitivity of severely injured patients, particularly in young age groups. A swift field triage process can maintain acceptable sensitivity and specificity in severely injured patients.

Matched MeSH terms: Triage

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