Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;225(4):508-515.
doi: 10.1016/j.jamcollsurg.2017.06.016. Epub 2017 Aug 30.

Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes

Benjamin Martinez  1 , John T Owings, Christopher Hector, Paige Hargrove, Shoichiro Tanaka, Margaret Moore, Patrick Greiffenstein, Joseph Giaimo, Shahrzad Talebinejad, John P Hunt
Affiliations

Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes

Benjamin Martinez et al. J Am Coll Surg. 2017 Oct.

Abstract

Background: The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not.

Study design: Trauma patients directed by LERN from the field in 2014 were included. Patients who followed the LERN communication center direction were considered the compliant group. Patients brought to a hospital inconsistent with the LERN direction were considered the noncompliant group. Chi-square analysis was used to compare differences between groups and a p value of <0.05 was considered statistically significant.

Results: During the study period, LERN directed 14,071 patients to a destination hospital. Prehospital providers were compliant with the LERN direction in 13,037 (92.7%) patients and noncompliant in 1,034 (7.3%) patients. There were fewer patients in the compliant group (570 of 13,037 [4.3%]) requiring transfer to a second hospital than in the noncompliant group (312 of 1,034 [30.2%]) (p < 0.01). The mortality rate was lower in the compliant group (81 of 13,037 [0.6%]) than in the noncompliant group (21 of 1,034 [2.03%]) (p < 0.01).

Conclusions: Following direction from a central communication center with real-time hospital capacity data yielded a 6-fold decrease in secondary transfer and a 3-fold decrease in mortality. These data emphasize the value of an organized statewide trauma network that routes patients to the appropriate facilities.

PubMed Disclaimer

References

REFERENCES

    1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Fatal injury reports 1999-2015. https://www.cdc.gov/injury/wisqars/fatal_injury_reports.html , 17, 2, 2014.
    1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Years of potential life lost (YPLL) 1999-2015. https://www.cdc.gov/injury/wisqars/years_potential.html , 17, 2, 2014.
    1. Mackenzie EJ, Rivara FP, Jurkovich GJ, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354:366-378.
    1. Newgard CD, McConnell KJ, Hedges JR, Mullins RJ. The benefit of higher level of care transfer of injured patients from nontertiery hospital emergency departments. J Trauma. 2007;63:965-971.
    1. Garwe T, Cowan LD, Neas B, et al. Survival benefit of transfer to tertiary trauma centers for major trauma patients initially presenting to nontertiary trauma centers. Acad Emerg Med. 2010;17:1223-1232.