Presentation Title
Undertriage of Traumatic Injury in a Rural EMS System: A Mixed Methods Analysis
Abstract
Traumatic injury is a leading cause of death among individuals aged 1-44 in the United States. The identification and appropriate treatment of severely injured patients is paramount to their survival, especially in rural settings such as Vermont. When patients are severely injured, they will often greatly benefit from care at a Level I Trauma Center: when this care is needed but not received, this is considered “undertriage.” Many Emergency Medical Services (EMS) personnel utilize the same guidelines to determine the severity of a patient’s injuries and the level of care they need: these guidelines however are complex and not often explicitly used: EMS providers instead frequently cite their judgement as the reason for taking patients to Trauma Centers. Though provider impression is often the deciding factor in whether this triage is properly performed according to established guidelines, previous studies have not investigated the elements composing provider impression, nor their effect on undertriage. This study has two aims: first, to retrospectively evaluate the undertriage rate in Vermont’s rural EMS system through record-level pre-hospital chart review. Secondly, this study aims to collect discrete choice experiment and focus group data to investigate which elements of the current triage protocols are most heavily relied on and influential of provider’s decisions. It is hoped that by combining this preference data with chart review and focus group discussions, a more complete picture of the state, and potential improvement areas, of prehospital trauma triage in Vermont’s rural trauma system.
Primary Faculty Mentor Name
Dale Jaffe
Status
Undergraduate
Student College
College of Arts and Sciences
Program/Major
Individually Design
Primary Research Category
Health Sciences
Secondary Research Category
Social Sciences
Undertriage of Traumatic Injury in a Rural EMS System: A Mixed Methods Analysis
Traumatic injury is a leading cause of death among individuals aged 1-44 in the United States. The identification and appropriate treatment of severely injured patients is paramount to their survival, especially in rural settings such as Vermont. When patients are severely injured, they will often greatly benefit from care at a Level I Trauma Center: when this care is needed but not received, this is considered “undertriage.” Many Emergency Medical Services (EMS) personnel utilize the same guidelines to determine the severity of a patient’s injuries and the level of care they need: these guidelines however are complex and not often explicitly used: EMS providers instead frequently cite their judgement as the reason for taking patients to Trauma Centers. Though provider impression is often the deciding factor in whether this triage is properly performed according to established guidelines, previous studies have not investigated the elements composing provider impression, nor their effect on undertriage. This study has two aims: first, to retrospectively evaluate the undertriage rate in Vermont’s rural EMS system through record-level pre-hospital chart review. Secondly, this study aims to collect discrete choice experiment and focus group data to investigate which elements of the current triage protocols are most heavily relied on and influential of provider’s decisions. It is hoped that by combining this preference data with chart review and focus group discussions, a more complete picture of the state, and potential improvement areas, of prehospital trauma triage in Vermont’s rural trauma system.