Evidence map›Paper›PMID 40056257›Full record

ArticleCJEM2025

Assessing the rates of overtriaging with prehospital trauma team activation protocols.

Kevin Durr, Krishan Yadav, Michael Ho, Jacinthe Lampron, Alexandre Tran, Doran Drew, Andrew Petrosoniak, Christian Vaillancourt, Natalia Kruger, Derek Goltz and 2 more

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Article in CJEM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Kevin DurrDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada. kedurr@toh.ca.ORCID 0000-0003-3866-0437
Krishan YadavDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Michael HoDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Jacinthe LampronClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Alexandre TranDepartment of Critical Care, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Doran DrewDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Andrew PetrosoniakDepartment of Emergency Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada.
Christian VaillancourtDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Natalia KrugerDivision of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Derek GoltzDivision of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Marie-Joe NemnomClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Jeffrey J PerryDepartment of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrehospital trauma team activation protocols are increasingly used to expedite clinical care and potentially improve patient outcomes. However, there is little evidence describing the rates of overtriaging following prehospital activation.

methodsIn June 2018, prehospital trauma team activation protocols were implemented at the Ottawa Hospital. We conducted a health records review of all adult trauma team activations at this Lead Trauma Hospital from September 2016 to March 2020. Cases were prospectively recorded in the regional trauma registry. Pre-implementation and post-implementation cohorts were divided based on the implementation date of the local activation protocols. Overtriaging rates were compared between both groups. We defined overtriaging as activating the trauma team without any of the following: death, ≥ 48-h admission, intensive care unit admission, operative management, or an injury severity score ≥ 16. We present descriptive statistics with odds ratios and 95% confidence intervals to describe the rates of overtriaging.

resultsWe analyzed 762 trauma team activations with 384 in the pre-implementation group and 378 in the post-implementation group. The frequency of prehospital trauma team activation was 25.3% (N = 97) in the pre-implementation period, compared to 47.6% (N = 180) in the post-implementation period. There was no statistically significant increase in overtriaging when comparing the pre-implementation (N = 64, 16.7%) and post-implementation (N = 68, 18.0%) groups (OR 1.10; 95% CI 0.75, 1.60). Furthermore, the rate of overtriaging for each individual criterion of the local protocol adhered to guideline recommendations (< 25-35%). Lastly, in the post-implementation period, there was no significant difference in overtriaging with prehospital (N = 30, 16.7%) compared to in-hospital (N = 38, 19.2%) trauma team activation (OR 0.84; 95% CI 0.50, 1.43).

conclusionOur study demonstrates that the local prehospital trauma team activation protocol did not result in a statistically significant rise in overtriaging. These findings demonstrate that implementing center-specific prehospital trauma team activation protocols did not increase overtriaging rates.

Indexed as

Clinical ProtocolsEmergency Medical ServicesPatient Care TeamRegistriesTrauma CentersWounds and InjuriesAdultFemaleHumansInjury Severity ScoreMaleMiddle AgedOntarioProspective StudiesRetrospective StudiesOvertriagingResource utilizationTrauma team activation

Identifiers

PMID40056257

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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.