Does EMS perceived anatomic injury predict trauma center need?

E. Brooke Lerner, Jennifer Roberts, Clare E. Guse, Manish N. Shah, Robert Swor, Jeremy T. Cushman, Alan Blatt, Gregory J. Jurkovich, Karen Brasel

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective. Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods. Emergency medical services (EMS) providers caring for injured adults transported to regional trauma centers in three midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon emergency department (ED) arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as nonorthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics, including positive likelihood ratios (+LRs) with 95% confidence intervals (CIs). Results. A total of 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9-4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1-19.4), paralysis (6.8; CI: 4.2-11.2), two or more long-bone fractures (6.3; CI: 4.5-8.9), and amputation (6.1; CI: 1.5-24.4). Criteria with a +LR >2 and

Original languageEnglish (US)
Pages (from-to)312-316
Number of pages5
JournalPrehospital Emergency Care
Volume17
Issue number3
DOIs
StatePublished - Jul 2013
Externally publishedYes

Fingerprint

Trauma Centers
Emergency Medical Services
Confidence Intervals
Wounds and Injuries
Flail Chest
Interviews
Motorcycles
Triage
Bone Fractures
Motor Vehicles
Amputation
Paralysis
Intensive Care Units
Hospital Emergency Service
Sensitivity and Specificity

Keywords

  • emergency medical services
  • emergency medical technicians
  • triage
  • wounds and injury

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Medicine(all)

Cite this

Lerner, E. B., Roberts, J., Guse, C. E., Shah, M. N., Swor, R., Cushman, J. T., ... Brasel, K. (2013). Does EMS perceived anatomic injury predict trauma center need? Prehospital Emergency Care, 17(3), 312-316. https://doi.org/10.3109/10903127.2013.785620

Does EMS perceived anatomic injury predict trauma center need? / Lerner, E. Brooke; Roberts, Jennifer; Guse, Clare E.; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Blatt, Alan; Jurkovich, Gregory J.; Brasel, Karen.

In: Prehospital Emergency Care, Vol. 17, No. 3, 07.2013, p. 312-316.

Research output: Contribution to journalArticle

Lerner, EB, Roberts, J, Guse, CE, Shah, MN, Swor, R, Cushman, JT, Blatt, A, Jurkovich, GJ & Brasel, K 2013, 'Does EMS perceived anatomic injury predict trauma center need?', Prehospital Emergency Care, vol. 17, no. 3, pp. 312-316. https://doi.org/10.3109/10903127.2013.785620
Lerner EB, Roberts J, Guse CE, Shah MN, Swor R, Cushman JT et al. Does EMS perceived anatomic injury predict trauma center need? Prehospital Emergency Care. 2013 Jul;17(3):312-316. https://doi.org/10.3109/10903127.2013.785620
Lerner, E. Brooke ; Roberts, Jennifer ; Guse, Clare E. ; Shah, Manish N. ; Swor, Robert ; Cushman, Jeremy T. ; Blatt, Alan ; Jurkovich, Gregory J. ; Brasel, Karen. / Does EMS perceived anatomic injury predict trauma center need?. In: Prehospital Emergency Care. 2013 ; Vol. 17, No. 3. pp. 312-316.
@article{f83479a420bb42419f9fd1ae03c1bf29,
title = "Does EMS perceived anatomic injury predict trauma center need?",
abstract = "Objective. Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods. Emergency medical services (EMS) providers caring for injured adults transported to regional trauma centers in three midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon emergency department (ED) arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as nonorthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics, including positive likelihood ratios (+LRs) with 95{\%} confidence intervals (CIs). Results. A total of 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26{\%}) needed the resources of a trauma center (38{\%} sensitivity, 91{\%} specificity, +LR 4.4; CI: 3.9-4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1-19.4), paralysis (6.8; CI: 4.2-11.2), two or more long-bone fractures (6.3; CI: 4.5-8.9), and amputation (6.1; CI: 1.5-24.4). Criteria with a +LR >2 and",
keywords = "emergency medical services, emergency medical technicians, triage, wounds and injury",
author = "Lerner, {E. Brooke} and Jennifer Roberts and Guse, {Clare E.} and Shah, {Manish N.} and Robert Swor and Cushman, {Jeremy T.} and Alan Blatt and Jurkovich, {Gregory J.} and Karen Brasel",
year = "2013",
month = "7",
doi = "10.3109/10903127.2013.785620",
language = "English (US)",
volume = "17",
pages = "312--316",
journal = "Prehospital Emergency Care",
issn = "1090-3127",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Does EMS perceived anatomic injury predict trauma center need?

AU - Lerner, E. Brooke

AU - Roberts, Jennifer

AU - Guse, Clare E.

AU - Shah, Manish N.

AU - Swor, Robert

AU - Cushman, Jeremy T.

AU - Blatt, Alan

AU - Jurkovich, Gregory J.

AU - Brasel, Karen

PY - 2013/7

Y1 - 2013/7

N2 - Objective. Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods. Emergency medical services (EMS) providers caring for injured adults transported to regional trauma centers in three midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon emergency department (ED) arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as nonorthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics, including positive likelihood ratios (+LRs) with 95% confidence intervals (CIs). Results. A total of 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9-4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1-19.4), paralysis (6.8; CI: 4.2-11.2), two or more long-bone fractures (6.3; CI: 4.5-8.9), and amputation (6.1; CI: 1.5-24.4). Criteria with a +LR >2 and

AB - Objective. Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods. Emergency medical services (EMS) providers caring for injured adults transported to regional trauma centers in three midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon emergency department (ED) arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as nonorthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics, including positive likelihood ratios (+LRs) with 95% confidence intervals (CIs). Results. A total of 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9-4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1-19.4), paralysis (6.8; CI: 4.2-11.2), two or more long-bone fractures (6.3; CI: 4.5-8.9), and amputation (6.1; CI: 1.5-24.4). Criteria with a +LR >2 and

KW - emergency medical services

KW - emergency medical technicians

KW - triage

KW - wounds and injury

UR - http://www.scopus.com/inward/record.url?scp=84878871083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878871083&partnerID=8YFLogxK

U2 - 10.3109/10903127.2013.785620

DO - 10.3109/10903127.2013.785620

M3 - Article

VL - 17

SP - 312

EP - 316

JO - Prehospital Emergency Care

JF - Prehospital Emergency Care

SN - 1090-3127

IS - 3

ER -