Comparison of American guidelines for field triage and Polish criteria as qualification to a trauma center

• Main Authors: Jacek Nowakowski, Rafał Nowakowski, Przemysław Biliński, Bogusława Nowak, Przemysław Wojciechowski, Michał Dworzyński, Marta Golis-Gucwa, Wojciech Timler, Małgorzata Timler, Dariusz Timler
• Format: Article
• Language: English
• Published: Institute of Rural Health 2019-09-01
• Series: Annals of Agricultural and Environmental Medicine
• Subjects: trauma; guidelines; decision making; emergency medical services; EMS; injury; triage; ISS; multiple organ injuries; trauma center
• Online Access: http://www.journalssystem.com/aaem/Comparison-of-American-Guidelines-for-Field-Triage-and-Polish-Criteria-as-qualification,100538,0,2.html

Introduction Trauma is the third cause of death among the general population in Poland, and the first in people aged 1–44 years. Trauma centers are hospitals dedicated to treating patients with multiple organ injuries, in a complex way that endeavours to ensure a lower mortality rate, shorter hospital stay and better outcomes if the patients are transferred to such a center. Worldwide, there are many models on how to treat a trauma patient, but them to be qualified for the procedure, the selection of potential patients is crucial. Objective The aim of the study was to compare the Polish model for qualification to a trauma center and American Guidelines for Field Triage. Material and methods Retrospective analysis of medical documentation recorded between 1 January 2014 – 31 December 2014 was undertaken. The study concerned trauma patients admitted to the Emergency Department of the Regional Trauma Center at the Copernicus Memorial Hospital in Łódź, Poland. Inclusion criterion was initial diagnosis ‘multiple-organ injury’ among patients transported by the Emergency Medical Service (EMS). Results In the period indicated, 3,173 patients were admitted to the Emergency Department at the Copernicus Memorial Hospital. From among them, 159 patients were included in the study. Only 13.2% of the patients fulfilled the Polish Qualification Criteria to Trauma Center in comparison to 87.4% who fulfilled the American Guidelines for Field Triage. Conclusions Polish qualification criteria do not consider the large group of patients with severe injuries (ISS>15), but indicate patients with minimal chance of survival. Polish criteria do not consider the mechanism of injury, which is a relevant predictive indicator of severe or extremely severe injuries (ISS>15). Further studies should be undertaken to improve the qualification and treatment of trauma patients in Poland.