Trauma Clinical Trial
Official title:
A Validation of Current Hospital Triage Performance System Versus RETTS and Identify Trauma Patient Outcome at Moi Teaching and Referral Hospital, Kenya.
Background: Triage in the emergency department (ED) together with initial assessment is used
to identify patient's level of urgency and treatment based on their triage level. Triage in
the ED is a complex decision-making process, and several triage scales have been designed as
decision support systems to guide the triage nurse to a correct decision. Worldwide there
are four well known five-level triage systems in use. In 2010, 97% of all EDs in Sweden
introduced a process-oriented triage scale with physiological parameters called Rapid
Emergency Traige and Treatment System (RETTS). RETTS has two main assessment variables:
vital signs and chief complaints, which describe the incident or symptoms that caused the
patient to seek care. These two variables are evaluated and results in a color coded 5-level
scale. Each level of priority has a defined time limit within which evaluation by a doctor
should begin. Although, all international triage system guidelines seem to function well in
western countries, they are difficult to implement and have a high failure rate in
developing low-income countries. One of the reasons may be the lack of extensive training.
Teaching and assessing abilities in performing mass casualty triage in inherently
challenging due to the inability to accurately replicate a given disaster environment in a
comprehensive way. Disaster drills and simulation exercises are ways of training triage
performance and there are different tools available. One tool that can contribute to this
kind of training may be the Emergo Train System® (ETS). ETS or similar interactive
educational simulation systems could be used to test and evaluate incident and command
systems, surge capacity, hospital preparedness and triage.
Study objective study III: The aim of the study is to validate the currently practiced
system for triage in the ED in Moi Teaching and Referral Hospital in Eldoret, Kenya with
RETTS. Furthermore map the current patient outcome of trauma patients.
A tool has been developed by the research group. It has been developed in which on
identification of trauma patient record, details will be entered and later transferred to an
Excel format for ease of analysis.
Trauma patient card record for collecting data including respiratory rate, pulse, blood
pressure, GCS, SaO2, body temperature, type of injury and mechanism of injury is developed
will be used. Time of accident and arrival to ED, sex, age and intervention at ED will also
be registered. Time at ED, number of days and where the patient has been treated during the
hospital visit are also going to be registered. According to the protocol there is also a
discharge evaluation where The International Classification of Disease (ICD) and Injury
Severity Score (ISS) will be registered.
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Observational Model: Cohort, Time Perspective: Prospective
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