Prehospital triage tools across the world: a scoping review of the published literature

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dc.contributor.authorBhaumik, Smitha
dc.contributor.authorHannun, Merhej
dc.contributor.authorDymond, Chelsea
dc.contributor.authorDeSanto, Kristen
dc.contributor.authorBarrett, Whitney
dc.contributor.authorWallis, Lee A
dc.contributor.authorMould-Millman, Nee-Kofi
dc.date.accessioned2022-05-03T07:13:57Z
dc.date.available2022-05-03T07:13:57Z
dc.date.issued2022-04-27
dc.date.updated2022-05-01T03:17:46Z
dc.description.abstractBackground: Accurate triage of the undifferentiated patient is a critical task in prehospital emergency care. However, there is a paucity of literature synthesizing currently available prehospital triage tools. This scoping review aims to identify published tools used for prehospital triage globally and describe their performance characteristics. Methods: A comprehensive search was performed of primary literature in English-language journals from 2009 to 2019. Papers included focused on emergency medical services (EMS) triage of single patients. Two blinded reviewers and a third adjudicator performed independent title and abstract screening and subsequent full-text reviews. Results: Of 1521 unique articles, 55 (3.6%) were included in the final synthesis. The majority of prehospital triage tools focused on stroke (n = 19; 35%), trauma (19; 35%), and general undifferentiated patients (15; 27%). All studies were performed in high income countries, with the majority in North America (23, 42%) and Europe (22, 40%). 4 (7%) articles focused on the pediatric population. General triage tools aggregate prehospital vital signs, mental status assessments, history, exam, and anticipated resource need, to categorize patients by level of acuity. Studies assessed the tools’ ability to accurately predict emergency department triage assignment, hospitalization and short-term mortality. Stroke triage tools promote rapid identification of patients with acute large vessel occlusion ischemic stroke to trigger timely transport to diagnostically- and therapeutically-capable hospitals. Studies evaluated tools’ diagnostic performance, impact on tissue plasminogen activator administration rates, and correlation with in-hospital stroke scales. Trauma triage tools identify patients that require immediate transport to trauma centers with emergency surgery capability. Studies evaluated tools’ prediction of trauma center need, under-triage and over-triage rates for major trauma, and survival to discharge. Conclusions: The published literature on prehospital triage tools predominantly derive from high-income health systems and mostly focus on adult stroke and trauma populations. Most studies sought to further simplify existing triage tools without sacrificing triage accuracy, or assessed the predictive capability of the triage tool. There was no clear ‘gold-standard’ singular prehospital triage tool for acute undifferentiated patients. Trial registration Not applicable.en_US
dc.identifier.apacitationBhaumik, S., Hannun, M., Dymond, C., DeSanto, K., Barrett, W., Wallis, L. A., & Mould-Millman, N. (2022). Prehospital triage tools across the world: a scoping review of the published literature. <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i>, 30(1), 32. http://hdl.handle.net/11427/36407en_ZA
dc.identifier.chicagocitationBhaumik, Smitha, Merhej Hannun, Chelsea Dymond, Kristen DeSanto, Whitney Barrett, Lee A Wallis, and Nee-Kofi Mould-Millman "Prehospital triage tools across the world: a scoping review of the published literature." <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine</i> 30, 1. (2022): 32. http://hdl.handle.net/11427/36407en_ZA
dc.identifier.citationBhaumik, S., Hannun, M., Dymond, C., DeSanto, K., Barrett, W., Wallis, L.A. & Mould-Millman, N. 2022. Prehospital triage tools across the world: a scoping review of the published literature. <i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.</i> 30(1):32. http://hdl.handle.net/11427/36407en_ZA
dc.identifier.ris TY - Journal Article AU - Bhaumik, Smitha AU - Hannun, Merhej AU - Dymond, Chelsea AU - DeSanto, Kristen AU - Barrett, Whitney AU - Wallis, Lee A AU - Mould-Millman, Nee-Kofi AB - Background: Accurate triage of the undifferentiated patient is a critical task in prehospital emergency care. However, there is a paucity of literature synthesizing currently available prehospital triage tools. This scoping review aims to identify published tools used for prehospital triage globally and describe their performance characteristics. Methods: A comprehensive search was performed of primary literature in English-language journals from 2009 to 2019. Papers included focused on emergency medical services (EMS) triage of single patients. Two blinded reviewers and a third adjudicator performed independent title and abstract screening and subsequent full-text reviews. Results: Of 1521 unique articles, 55 (3.6%) were included in the final synthesis. The majority of prehospital triage tools focused on stroke (n = 19; 35%), trauma (19; 35%), and general undifferentiated patients (15; 27%). All studies were performed in high income countries, with the majority in North America (23, 42%) and Europe (22, 40%). 4 (7%) articles focused on the pediatric population. General triage tools aggregate prehospital vital signs, mental status assessments, history, exam, and anticipated resource need, to categorize patients by level of acuity. Studies assessed the tools’ ability to accurately predict emergency department triage assignment, hospitalization and short-term mortality. Stroke triage tools promote rapid identification of patients with acute large vessel occlusion ischemic stroke to trigger timely transport to diagnostically- and therapeutically-capable hospitals. Studies evaluated tools’ diagnostic performance, impact on tissue plasminogen activator administration rates, and correlation with in-hospital stroke scales. Trauma triage tools identify patients that require immediate transport to trauma centers with emergency surgery capability. Studies evaluated tools’ prediction of trauma center need, under-triage and over-triage rates for major trauma, and survival to discharge. Conclusions: The published literature on prehospital triage tools predominantly derive from high-income health systems and mostly focus on adult stroke and trauma populations. Most studies sought to further simplify existing triage tools without sacrificing triage accuracy, or assessed the predictive capability of the triage tool. There was no clear ‘gold-standard’ singular prehospital triage tool for acute undifferentiated patients. Trial registration Not applicable. DA - 2022-04-27 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine KW - Prehospital KW - Triage KW - Trauma KW - Stroke KW - Emergency medical services KW - EMS KW - Tools KW - Scoping review KW - Global health KW - International LK - https://open.uct.ac.za PY - 2022 T1 - Prehospital triage tools across the world: a scoping review of the published literature TI - Prehospital triage tools across the world: a scoping review of the published literature UR - http://hdl.handle.net/11427/36407 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13049-022-01019-z
dc.identifier.urihttp://hdl.handle.net/11427/36407
dc.identifier.vancouvercitationBhaumik S, Hannun M, Dymond C, DeSanto K, Barrett W, Wallis LA, et al. Prehospital triage tools across the world: a scoping review of the published literature. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2022;30(1):32. http://hdl.handle.net/11427/36407.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Emergency Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceScandinavian Journal of Trauma, Resuscitation and Emergency Medicineen_US
dc.source.journalissue1en_US
dc.source.journalvolume30en_US
dc.source.pagination32en_US
dc.source.urihttps://sjtrem.biomedcentral.com/
dc.subjectPrehospitalen_US
dc.subjectTriageen_US
dc.subjectTraumaen_US
dc.subjectStrokeen_US
dc.subjectEmergency medical servicesen_US
dc.subjectEMSen_US
dc.subjectToolsen_US
dc.subjectScoping reviewen_US
dc.subjectGlobal healthen_US
dc.subjectInternationalen_US
dc.titlePrehospital triage tools across the world: a scoping review of the published literatureen_US
dc.typeJournal Articleen_US
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