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Potential benefits of triage for the trauma patient in a Kenyan emergency department

机译：肯尼亚急诊科对创伤患者进行分诊的潜在好处

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Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country. A prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records. A total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories. The results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.
机译：改善创伤管理可以减少伤害和医疗干预之间的时间，从而降低发病率和死亡率。急诊科的分诊对于确保对受伤患者进行优先排序和及时评估至关重要。本研究的目的是调查缺乏正式的分诊系统如何影响撒哈拉以南转诊医院的及时干预和死亡率。此外，该研究试图评估分流对一个中等收入国家有效管理创伤患者的潜在好处。进行了一项前瞻性描述性研究。包括在肯尼亚埃尔多雷特的Moi教学与转诊医院在8个月内入住急诊室的成年创伤患者。登记到达方式和重要参数。分析中包括的变量包括损伤严重度评分，评估医生之前的时间，住院时间和死亡率。根据患者记录，根据快速紧急分诊和治疗系统（RETTS）对患者进行回顾性分类。分析了总共571例患者，平均损伤严重程度评分为12.2（SD 7.7），平均住院时间为11.6（SD 18.3）天。死亡率为1.8％。这项研究获得的结果表明，未及时评估进入Eldoret急诊室的创伤患者，并且未遵守RETTS提出的时间框架建议。根据所使用的分类算法对患者进行评估后，发现红色类别的平均伤害严重度评分显着高于其他颜色类别。这项研究的结果清楚地表明，与及时评估的需要相比，缺乏对患者正确的优先排序。患者的回顾性分流分类进一步证明了这一点，该分类将ISS高的患者确定为急需护理。由于观察到的无论损伤严重程度的评估时间均无显着差异，因此显然需要功能良好的分类系统。

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