¿Es útil el juicio del sanitario en el triage del traumatismo prehospitalario?

Stephen A. Mulhollanda, c, Belinda J. Gabbeb, Peter Cameronb, d, , and Victorian State Trauma Outcomes Registry and Monitoring Group (VSTORM)

aVictorian Trauma Foundation Centre for Trauma Research and Practice, Melbourne, Australia bDepartment of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, The Alfred Hospital, Commercial Rd., Melbourne, 3004 Vic., Australia cMetropolitan Ambulance Service, Melbourne, Australia dNational Trauma Research Institute at The Alfred Hospital, Melbourne, Australia

Summary Precise prehospital trauma triage criteria are critical for ensuring patients with severe injuries are transported to trauma centres. Most prehospital trauma triage criteria adopt a combination of physiological, anatomic and mechanism of injury components, but this approach still fails to identify a number of patients with severe injuries and often burdens trauma centres with patients suffering minor injuries. Paramedic judgement has been identified as an alternative method for the triage of trauma patients. This study critically reviewed the literature regarding the ability of paramedics to predict injury severity, and found there is no clear evidence supporting paramedic judgement as an accurate triage method. However, the studies were limited due to significant data losses, variable definitions of major trauma, differences across EMS and trauma care systems, variable paramedic experience levels and incomparable methods of data collection. The role of paramedic judgement in identifying patients with severe blunt anatomic injuries requires further investigation.

Injury Volume 36, Issue 11 , November 2005, Pages 1298-1305