Emerman C L, Shade B, Kubincanek J
Department of Emergency Medicine, MetroHealth Medical Center, Cleveland, OH 44109.
J Trauma. 1991 Oct;31(10):1369-75. doi: 10.1097/00005373-199110000-00009.
A number of instruments have been devised to aid in the triage of trauma patients. Little work, however, has been done to demonstrate that these triage instruments offer an advantage over the judgment of an emergency medical technician (EMT) in determining which patients require transportation to a trauma center. The purpose of this study was to compare EMT judgment against three scoring systems; the triage-revised Trauma Score, the Prehospital Index, and the CRAMS scale. Data were gathered on trauma victims transported by the City of Cleveland EMS system. The EMTs rated the patient's overall severity on a 4-point scale and estimated the probability of patient mortality. We found that the EMT prediction of mortality was as accurate as the various scores. In a subset of patients, we also found that the EMT assessment performed as well as the scoring systems in identifying patients who either died or required emergent operative intervention. We conclude that EMT judgment is as accurate as these three scoring systems in identifying patients at high risk for death or the need for immediate operative intervention.
已经设计了许多仪器来辅助创伤患者的分诊。然而，几乎没有研究表明这些分诊仪器在确定哪些患者需要转运至创伤中心方面比急诊医疗技术人员（EMT）的判断更具优势。本研究的目的是将EMT的判断与三种评分系统进行比较；分诊修订创伤评分、院前指数和CRAMS量表。收集了由克利夫兰市紧急医疗服务系统运送的创伤受害者的数据。EMT对患者的总体严重程度进行四分制评分，并估计患者的死亡率。我们发现，EMT对死亡率的预测与各种评分一样准确。在一部分患者中，我们还发现，EMT的评估在识别死亡或需要紧急手术干预的患者方面与评分系统表现相当。我们得出结论，在识别死亡高风险或需要立即手术干预的患者方面，EMT的判断与这三种评分系统一样准确。
