Evidence map›Paper›PMID 37001975›Full record

ReviewCanadian journal of surgery. Journal canadien de chirurgie

A Canadian consensus-based list of urgent and specialized in-hospital trauma care interventions to assess the accuracy of prehospital trauma triage protocols: a modified Delphi study.

Éric Mercier, Alexandra Nadeau, Natalie Le Sage, Lynne Moore, Christian Malo, Pierre-Gilles Blanchard, Richard Fleet, Marcel Émond

Open access · diamondAbstract readReviewConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Review in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Inter-facility transfers to an urban level 1 trauma center and rates of secondary overtriage.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  3. Article
  4. 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

8 authors at 3 institutions in 2 countries.

Éric MercierFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore) eric.mercier@fmed.ulaval.ca.
Alexandra NadeauFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Natalie Le SageFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Lynne MooreFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Christian MaloFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Pierre-Gilles BlanchardFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Richard FleetFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Marcel ÉmondFrom VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Que. (Mercier, Nadeau, Le Sage, Blanchard, Fleet, Émond); the Centre de recherche du CHU de Québec - Université Laval, Québec, Que. (Nadeau, Moore, Malo); the Département de médecine d'urgence, CHU de Québec, Québec, Que. (Mercier, Le Sage, Malo, Blanchard, Émond); and the Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Que. (Moore).
Université Laval · CACentre hospitalier de l'Université Laval · CASage (United Kingdom) · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInjury severity scales have traditionally been used to assess the performance of prehospital trauma triage protocols, but they correlate weakly with the urgent needs of specialized trauma care interventions. This study aimed to develop a list of in-hospital urgent and specialized trauma care interventions that require direct transport to the highest-level trauma centre within the catchment area.

methodsBased on a list of potential participants we obtained using data on training, experience, geographic location, affiliations and role within key trauma organizations, we recruited multidisciplinary trauma experts (including prehospital, emergency, surgery and intensive care clinicians, epidemiologists and clinician/decision-makers) from across Canada to complete a 3-round modified Delphi survey. We conducted a literature review of the criteria used to define urgent and specialized trauma care, and included all diagnostic and therapeutic interventions presented in previously published studies in the list of interventions to present to the panellists. The final list was determined by our advisory committee, 5 clinicians with experience in trauma care. Participants were asked to rate their level of agreement for potentially including the 38 items as urgent and specialized trauma care interventions on a 9-point Likert scale. Interventions were retained if more than 67% of participants moderately or strongly agreed (7-9 on the Likert scale). Interventions that did not reach consensus were presented again in the subsequent round.

resultsTwenty-three panellists were recruited. The response rate was 91%, 96% and 83% for the 3 rounds. After the Delphi process, 30 of the 38 interventions, including endotracheal intubation, blood product administration and angioembolization, and abdominal, thoracic, neurosurgical, spinal and/or orthopedic operations (excluding hip or limb surgery, and toe or finger amputation), were selected. Hospital admission to the intensive care unit and/or for observation of brain, spinal, thoracic or abdominal injuries were also retained.

conclusionWe developed a Canadian consensus-based list of urgent and specialized in-hospital trauma care interventions requiring direct transportation to a major trauma centre. This list should help standardize assessments of current protocols and derive new triage tools.

Indexed as

Emergency Medical ServicesTriageCanadaDelphi TechniqueHospitalsHumans

Identifiers

PMID37001975
PMCPMC10069413
OpenAlexW4362475635

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.