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Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community

BACKGROUND: Priority grade assessment according to urgency level of the patients (triage) is considered vital in emergency medicine casualties. Little is known of the experiences of pre-hospital emergency medicine triage performed by General Practitioners (GPs) in the community. In this study we bri...

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Autores principales: Rørtveit, Sverre, Meland, Eivind, Hunskaar, Steinar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878323/
https://www.ncbi.nlm.nih.gov/pubmed/24354953
http://dx.doi.org/10.1186/1757-7241-21-89
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author Rørtveit, Sverre
Meland, Eivind
Hunskaar, Steinar
author_facet Rørtveit, Sverre
Meland, Eivind
Hunskaar, Steinar
author_sort Rørtveit, Sverre
collection PubMed
description BACKGROUND: Priority grade assessment according to urgency level of the patients (triage) is considered vital in emergency medicine casualties. Little is known of the experiences of pre-hospital emergency medicine triage performed by General Practitioners (GPs) in the community. In this study we bring such experiences from a Norwegian island community, with special emphasis on over- and undertriage. METHODS: In the island municipality of Austevoll, Western Norway, where the GPs and the ambulance services both take part in all medical emergency cases, all these cases were recorded during a 2-year period (2005–2007). We compared the triage of the patients at the stage of the telephone reception of the incident, and the subsequent revision of the triage at the first personal examination of the patient. RESULTS: 236 emergency medical events were recorded, comprising 240 patients. Of these, 42% were downgraded between the stages (i.e. initially overtriaged), 11% were upgraded (i.e. initially undertriaged) and 47% remained in unchanged priority group. Of the diagnostic groups, acute abdominal cases had the highest probability of being upgraded between stages, while the aggregated diagnostic group of syncopes, seizures, intoxications and traumas had the highest probability of being downgraded. The principal reason for upgrading was lack of necessary information at the stage of call. In a minority of cases the upgrading was due to real patient deterioration between stages. CONCLUSIONS: In pre-hospital triage of emergency patients, downgrading happens between notification of events and actual patient examination in a substantial proportion. Upgradings of cases are considerably fewer, but the potential serious implications of upgrading warrants individual scrutiny of such cases.
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spelling pubmed-38783232014-01-03 Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community Rørtveit, Sverre Meland, Eivind Hunskaar, Steinar Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Priority grade assessment according to urgency level of the patients (triage) is considered vital in emergency medicine casualties. Little is known of the experiences of pre-hospital emergency medicine triage performed by General Practitioners (GPs) in the community. In this study we bring such experiences from a Norwegian island community, with special emphasis on over- and undertriage. METHODS: In the island municipality of Austevoll, Western Norway, where the GPs and the ambulance services both take part in all medical emergency cases, all these cases were recorded during a 2-year period (2005–2007). We compared the triage of the patients at the stage of the telephone reception of the incident, and the subsequent revision of the triage at the first personal examination of the patient. RESULTS: 236 emergency medical events were recorded, comprising 240 patients. Of these, 42% were downgraded between the stages (i.e. initially overtriaged), 11% were upgraded (i.e. initially undertriaged) and 47% remained in unchanged priority group. Of the diagnostic groups, acute abdominal cases had the highest probability of being upgraded between stages, while the aggregated diagnostic group of syncopes, seizures, intoxications and traumas had the highest probability of being downgraded. The principal reason for upgrading was lack of necessary information at the stage of call. In a minority of cases the upgrading was due to real patient deterioration between stages. CONCLUSIONS: In pre-hospital triage of emergency patients, downgrading happens between notification of events and actual patient examination in a substantial proportion. Upgradings of cases are considerably fewer, but the potential serious implications of upgrading warrants individual scrutiny of such cases. BioMed Central 2013-12-19 /pmc/articles/PMC3878323/ /pubmed/24354953 http://dx.doi.org/10.1186/1757-7241-21-89 Text en Copyright © 2013 Rørtveit et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Rørtveit, Sverre
Meland, Eivind
Hunskaar, Steinar
Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title_full Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title_fullStr Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title_full_unstemmed Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title_short Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian rural community
title_sort changes of triage by gps during the course of prehospital emergency situations in a norwegian rural community
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878323/
https://www.ncbi.nlm.nih.gov/pubmed/24354953
http://dx.doi.org/10.1186/1757-7241-21-89
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