安全且具成本效益的儿科创伤分诊标准：院前评估与受伤儿童的分流

Criteria for safe cost-effective pediatric trauma triage: prehospital evaluation and distribution of injured children.

作者信息

Sola J E, Scherer L R, Haller J A, Colombani P M, Papa P A, Paidas C N

机构信息

Department of Surgery, Johns Hopkins University, Baltimore, MD 21205.

出版信息

J Pediatr Surg. 1994 Jun;29(6):738-41. doi: 10.1016/0022-3468(94)90358-1.

DOI:10.1016/0022-3468(94)90358-1

PMID:8078009

Abstract

In an effort to maximize staff utilization, all pediatric trauma patients were triaged by emergency room personnel to one of two tiers, based on information reported by prehospital providers over radiotelephones. A total of 952 patients less than 15 years of age were evaluated during a 1-year period. The triage criteria had a sensitivity of 86% in predicting which trauma patients would require operating room and/or pediatric intensive care, while maintaining a specificity of 90%. Fifteen patients died; however, by TRISS methodology there were no unexpected deaths and four unexpected survivors. All eventual deaths were initially captured from field data by the severely injured triage criteria. The study data suggest that physician-controlled two-tiered field triage criteria can safely serve to maximize staff utilization in the emergency room.

摘要

为了最大限度地提高工作人员的利用率，急诊室人员根据院前急救人员通过无线电话报告的信息，将所有儿科创伤患者分为两级中的一级。在1年的时间里，共评估了952名15岁以下的患者。分诊标准在预测哪些创伤患者需要手术室治疗和/或儿科重症监护方面的敏感性为86%，同时特异性保持在90%。15名患者死亡；然而，根据创伤和损伤严重程度评分系统（TRISS）方法，没有意外死亡病例，有4名意外幸存者。所有最终死亡病例最初都通过重伤分诊标准从现场数据中筛选出来。研究数据表明，由医生控制的两级现场分诊标准可以安全地用于最大限度地提高急诊室工作人员的利用率。