Retrospective Assessment of Referral of a Major Trauma Patient in Val-d'Oise
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 461
- 试验地点
- 1
- 主要终点
- Triage assessment of a major trauma patient
研究概览
简要总结
The aim of this study is to find out whether major trauma patients from the Val d'Oise are referred to the appropriate trauma centre for their care and to assess the quality of triage within the Val d'Oise department.
详细描述
In France, the number of major trauma is estimated at between 15,000 and 20,000 per year. It is the leading cause of death in patients under the age of 40, and is a significant source of long-term dependency. Mortality from severe trauma varies depending on the region and the circumstances of the accident. Effective initial care and referral to specialist trauma centres are crucial to improving survival. Access to these centres must be guaranteed throughout France. Trauma centres play a central role in the management of serious trauma patients. They are classified by level, from level I to level III.
The triage process aims to direct the patient to the trauma centre with the appropriate level of care. The challenge is to send the "right patient to the right place at the right time". Over-triage and under-triage are two critical concepts in the management of trauma patients. Over-triage (patients considered to be more seriously injured than they really are) leads to excessive consumption of resources and increases waiting times for patients who really need a level I or II trauma centre. Under-triage (patients considered to be less seriously injured than they really are), is characterised by patients being referred to a trauma centre that is insufficiently equipped for their needs, compromises their chances of survival and recovery. In both cases, the loss of chance for the patient is real.
The aim of this study is to find out whether major trauma patients from the Val d'Oise are referred to the appropriate trauma centre for their care, and to assess the quality of triage within the Val d'Oise department.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Triage assessment of a major trauma patient
时间窗: At the end of the study, an average of 9 month
The criterion is the evaluation of the referral of the major trauma patient after post-Medics injury assessment into over, normo and under-triage The over-triage patient is referred to a level I trauma centre with an Injury Severity Score (ISS) \<16 The normo-triage patients are either referred to: * a level 1 trauma centre with an ISS \>15 * the local scanner and then to an intensive care unit at the scanner site * in the emergency department and then to a surgical unit * emergency with a return home afterwards The under-triage patient is either referred to: * the local scanner and then to a level 1 trauma centre * initially emergency with hospitalisation in an intensive care or continuing care unit afterwards
次要结局
- Assess if presumed alcohol intoxication is correlated with a higher rate of under-triage(At the end of the study, an average of 9 month)
- Assess if the TRENAU grade is predictive in pre-hospital of an appropriate referral following an intra-hospital trauma assessment(At the end of the study, an average of 9 month)
- Assess if the positive Shock-Index is predictive of an appropriate pre-hospital referral to a level 1 trauma centre(At the end of the study, an average of 9 month)
- Assess if the MGAP is predictive of an appropriate referral following an intra-hospital trauma assessment(At the end of the study, an average of 9 month)
- Assess if the intervention time is correlated with an under-triage(At the end of the study, an average of 9 month)
- Assess if deliberate toxic poisoning is correlated with a higher rate of under-triage(At the end of the study, an average of 9 month)
- Assess if the positive Shock-Index ( ≥ 0.9 ) is predictive of an intra-hospital blood transfusion(At the end of the study, an average of 9 month)