Evidence map›Paper›PMID 35128069›Full record

ArticleTrauma surgery & acute care open2022

The national trauma triage protocol: how EMS perspective can inform the guideline revision.

Peter E Fischer, Mark L Gestring, Scott G Sagraves, Holly N Michaels, Bhavin Patel, Jimm Dodd, Eric M Campion, Wayne E VanderKolk, Eileen M Bulger

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Peter E FischerDepartment of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Mark L GestringDepartment of Surgery, University of Rochester, Rochester, New York, USA.
Scott G SagravesDepartment of Surgery, Baylor Scott and White Central Texas, Temple, Texas, USA.
Holly N MichaelsCommittee on Trauma, American College of Surgeons, Chicago, Illinois, USA.
Bhavin PatelCommittee on Trauma, American College of Surgeons, Chicago, Illinois, USA.
Jimm DoddCommittee on Trauma, American College of Surgeons, Chicago, Illinois, USA.
Eric M CampionDepartment of Surgery, Denver Health, Denver, Colorado, USA.
Wayne E VanderKolkDepartment of Surgery, West Michigan Surgical Specialists, Grand Rapids, Michigan, USA.
Eileen M BulgerDepartment of Surgery, University of Washington, Seattle, Washington, USA.
American College of Surgeons · USBaylor Scott & White Medical Center - Temple · USRetina Specialists of Michigan · USUniversity of Colorado Denver · USUniversity of Rochester · USUniversity of Tennessee Health Science Center · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe Field Triage Guidelines (FTG) support emergency medical service (EMS) decisions regarding the most appropriate transport destination for injured patients. While the components of the algorithm are largely evidenced-based, the stepwise approach was developed with limited input from EMS providers. FTG are only useful if they can easily be applied by the field practitioner. We sought to gather end-user input on the current guidelines from a broad group of EMS stakeholders to inform the next revision of the FTG.

methodsAn expert panel composed an end-user feedback tool. Data collected included: demographics, EMS agency type, geographic area of respondents, use of the current FTG, perceived utility, and importance of each step in the algorithm (1: physiologic, 2: anatomic, 3 mechanistic, 4: special populations). The American College of Surgeons Committee on Trauma (ACS COT), in partnership with several key organizations, distributed the tool to reach as many providers as possible.

results3958 responses were received (82% paramedics/emergency medical technicians, 9% physicians, 9% other). 94% responded directly to scene emergency calls and 4% were aeromedical providers. Steps 2 and 3 were used in 95% of local protocols, steps 1 and 4 in 90%. Step 3 was used equally in protocols across all demographics; however, step 1 was used significantly more in the air medical services than ground EMS (96% vs 88%, p<0.05). Geographic variation was demonstrated in FTG use based on the distance to a trauma center, but step 3 (not step 1) drove the majority of the decisions. This point was reinforced in the qualitative data with the comment, "I see the wreck before I see the patient."

conclusionThe FTG are widely used by EMS in the USA. The stepwise approach is useful; however, mechanism (not physiological criteria) drives most of the decisions and is evaluated first. Revision of the FTG should consider the experience of the end-users. LEVEL OF EVIDENCE: V.

Indexed as

emergency medical servicesEMSmultiple traumatriage

Identifiers

PMID35128069
PMCPMC8768919
OpenAlexW4205655239

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.