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Trauma bypass in south‐eastern Sydney: An 8‐year review
Author(s) -
Macken Lewis,
Manovel Alvaro
Publication year - 2005
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2005.00705.x
Subject(s) - medicine , triage , major trauma , emergency department , emergency medicine , injury severity score , medical emergency , revised trauma score , injury prevention , poison control , psychiatry
Abstract Objective: The New South Wales (NSW) Health Department and the Ambulance Service of NSW introduced a trauma bypass system in Sydney on 29 March 1992. This study aims to review the outcomes of trauma bypass patients brought to St George Hospital, a major trauma service in south‐eastern Sydney, and to assess the performance of the current prehospital trauma triage protocol. Methods: The St George Hospital Department of Trauma Services prospectively collected data on all trauma bypass patients for the 8‐year period from 29 March 1992 to 29 March 2000. Results: A total of 1990 patients were brought to hospital on trauma bypass. The average age was 32 years, 70% were men and 66% were from road traffic accidents. The positive predictive value of the prehospital triage tool for serious injury (Injury Severity Score [ISS] > 15) was 18.6% (95% CI 16.9–20.4). This is well below the benchmark previously established by the NSW Health Department Trauma System Advisory Committee. For all trauma bypass patients, 33.8% (95% CI 31.7–35.9) were discharged home from the ED. The overall death rate was 2.5% (95% CI 1.9–3.3). Conclusions: According to the proposed benchmark, current prehospital trauma triage guidelines are underperforming. This suggests that a review of the benchmarks of current local trauma systems and of the trauma triage tool is required.