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Potential benefits of triage for the trauma patient in a Kenyan emergency department
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
Department of Disaster Risk Management, Moi University College of Health and Science, Eldoret, Kenya.
Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences.ORCID iD: 0000-0003-2771-2705
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2018 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, article id 49Article in journal (Refereed) Published
Abstract [en]

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 18, article id 49
Keywords [en]
Triage, Trauma, Emergency department
National Category
Anesthesiology and Intensive Care
Research subject
Disaster Medicine
Identifiers
URN: urn:nbn:se:liu:diva-153305DOI: 10.1186/s12873-018-0200-7ISI: 000452637100002PubMedID: 30497397Scopus ID: 2-s2.0-85057551142OAI: oai:DiVA.org:liu-153305DiVA, id: diva2:1269818
Note

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2020-02-04Bibliographically approved

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Lampi, MariaJunker, JohanBerggren, PeterJonson, Carl-OscarWladis, Andreas

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Lampi, MariaJunker, JohanBerggren, PeterJonson, Carl-OscarWladis, Andreas
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesCenter for Disaster Medicine and TraumatologyHuman-Centered systemsFaculty of Arts and Sciences
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