Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian
rural community
Engelsk titel: Changes of triage by GPs during the course of prehospital emergency situations in a Norwegian
rural community
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Författare:
Rörtveit, Sverre
;
Meland, Eivind
;
Hunskaar, Steinar
Email: sverre.rortveit@aknett.net
Språk: Eng
Antal referenser: 9
Dokumenttyp:
Artikel
UI-nummer: 14099009
Sammanfattning
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.