Journal article
Success Of An Expedited Emergency Department Triage Evaluation System For Geriatric Trauma Patients Not Meeting Trauma Activation Criteria
Open access emergency medicine, v 11, pp 241-247
01 Oct 2019
PMID: 31754315
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Geriatric patients are at increased risk of injury following low-energy mechanisms and are less tolerant of injury. Current criteria for trauma team activation (TTA) often miss these injuries. We evaluated a novel triage process for an expedited Emergency Medicine Physician evaluation protocol (T3) for at-risk geriatric sub-populations not meeting trauma team activation (TTA) criteria.
Methods: Retrospective review of injured patients (>= 65 years) from a Level II Trauma Center with an Injury Severity Score (ISS < 16), prior to (Pre-T3, Jan 2007-Oct 2009), and after (Post-T3, Jan 2010-Oct 2012), implementation of T3, as well as a contemporary period (CP, Jan 2013-Oct 2015). Demographics, physiologic variables, and timeliness of care were measured. Rates of ICU admission, operative procedures and lengths of stay and in-hospital mortality were compared for all periods. Logistic regression analysis determined variables independently associated with mortality.
Results: Post-T3, 49.2% of geriatric registry patients underwent T3 with a reduction in key time intervals. Median time to evaluation (42.1 mins vs 61.7 min, p<0.001), median time to CT (161.3 mins vs 212.9 mins, p<0.001) and EDLOS (364.6 mins vs 451.5 mins, p=0.023) were all reduced compared to non-expedited evaluations. There was no change in mortality after the implementation of the protocol.
Conclusion: The T3 protocol expedited patient evaluation of at-risk geriatric patients that would not otherwise meet TTA criteria. The new process met the goals of the American College of Surgeons Trauma Quality Improvement Program while conserving resources.
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Details
- Title
- Success Of An Expedited Emergency Department Triage Evaluation System For Geriatric Trauma Patients Not Meeting Trauma Activation Criteria
- Creators
- Forrest B. Fernandez - Reading HospitalAdrian Ong - Reading HospitalAnthony P. Martin - Reading HospitalC. William Schwab - Hospital of the University of PennsylvaniaTom Wasser - Complete Stat Serv, Macungie, PA USAChristopher A. Butts - Philadelphia College of Osteopathic MedicineAmanda R. McNicholas - Reading HospitalAlison L. Muller - Reading HospitalCharles F. Barbera - Reading HospitalRachael Trupp - Reading HospitalAdam P. Sigal - Reading Hospital
- Publication Details
- Open access emergency medicine, v 11, pp 241-247
- Publisher
- Dove Medical Press Ltd
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery; Emergency Medicine
- Web of Science ID
- WOS:000494667400001
- Scopus ID
- 2-s2.0-85074404234
- Other Identifier
- 991021929614904721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine