Potential benefits of triage for the trauma patient in a Kenyan emergency department

Abstract

BackgroundImproved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.MethodsA prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.ResultsA total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.ConclusionThe results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.

Emergency Department Nurses’ Knowledge Regarding Triage

“…These results were in contrast with those obtained by Cantor et al (2012) findings who stated that almost half of the respondent had no knowledge on time limits for the triaged categories. The reason for performing triage in an emergency department is to ensure that each patient is treated in the order of clinical urgency and that the treatment is appropriate and timely (Lampi et al, 2018).…”

A baseline review of the ability of hospitals in Kenya to provide emergency and critical care services for COVID-19 patients

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5G enabled Mobile Operating Hospital and Emergency Care Service

“…These tests determine the kind of treatment protocol the patient requires [6]. Triage is considered efficient in terms of time-saving as it paves the way for precision treatment [7]. However, it is undeniable that pre-hospital occurence of these tests could prove life-saving for the patient.…”

“…Hence, there is a need for the development and deployment of reconfigurable RAT components for an integrated terrestrialspace communication applications [6,7]. Moreover, this architecture is promising for 5G vertical use cases applications that rely heavily on adaptive beamforming [5].…”