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ObjectivesTo evaluate the profile of non-urgent patients triaged ‘green’, as part of a triage trial in the emergency department (ED) of a secondary care hospital in India. The secondary aim was to validate the triage trial with the South African Triage Score (SATS).DesignProspective cohort study.SettingA secondary care hospital in Mumbai, India.ParticipantsPatients aged 18 years and above with a history of trauma defined as having any of the external causes of morbidity and mortality listed in block V01–Y36, chapter XX of the International Classification of Disease version 10 codebook, triaged green between July 2016 and November 2019.Primary and secondary outcome measuresOutcome measures were mortality within 24 hours, 30 days and mistriage.ResultsWe included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, and 77% were males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3–8), with the majority of injuries being blunt (98%). Of the patients triaged green by clinicians, three-quarters (74%) were undertriaged on validating with SATS. On telephonic follow-up, two patients were reported dead whereas one died while admitted in hospital.ConclusionsOur study highlights the need for implementation and evaluation of training in trauma triage systems that use physiological parameters, including pulse, systolic blood pressure and Glasgow Coma Scale, for the in-hospital first responders in the EDs.

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Introduction: Triage is an important component of in-hospital trauma care for adequate patient management and to avoid overcrowding in emergency departments (ED). Prioritising the evaluation of non-urgent patients may result in the diversion of workforce from patients requiring immediate care. However, not evaluating these patients may result in missed injuries and poor outcomes. We aimed to evaluate the profile of these non-urgent patients triaged ‘green’, as part of a triage-trial in a secondary-care hospital in India and validate this against the Cape Triage Score (CTS).Methods: We analysed data of patients triaged green in a prospective single-centre cohort study between July 2016 to November 2019. Clinicians at this triage-naive ED were introduced to a triage trial who then assigned a triage category to trauma patients, aged 18 years and above, on initial evaluation. Telephonic follow-up was performed for all patients included in the study. Triage appropriateness was retrospectively analysed using the CTS. Results: We included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, 77% males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3-8), with the majority of injuries being blunt (98%). Of the patients triaged green, 97% came in as direct arrivals and 94.4% were discharged from the ED after initial evaluation. As per CTS, nearly three-quarters (74%) of patients were undertriaged ‘green’ by the clinicians in a triage-naive ED. Conclusion: ​​ Three-fourths (74%) of the patients triaged green by clinicians in a secondary care hospital in Mumbai were mistriaged when retrospectively analysed using CTS. This highlights the need for implementation and evaluation of trauma triage training for the in-hospital first responders (clinicians, nurses and other paramedical staff) in the EDs.

Introduction: Triage is an important component of in-hospital trauma care for adequate patient management and to avoid overcrowding in emergency departments (ED). Prioritising the evaluation of non-urgent patients may result in the diversion of workforce from patients requiring immediate care. However, not evaluating these patients may result in missed injuries and poor outcomes. We aimed to evaluate the profile of these non-urgent patients triaged ‘green’, as part of a triage-trial in a secondary-care hospital in India and validate this against the Cape Triage Score (CTS).Methods: We analysed data of patients triaged green in a prospective single-centre cohort study between July 2016 to November 2019. Clinicians at this triage-naive ED were introduced to a triage trial who then assigned a triage category to trauma patients, aged 18 years and above, on initial evaluation. Telephonic follow-up was performed for all patients included in the study. Triage appropriateness was retrospectively analysed using the CTS. Results: We included 4135 trauma patients triaged green. The mean age of patients was 32.8 (±13.1) years, 77% males. The median (IQR) length of stay of admitted patients was 3 (13) days. Half the patients had a mild Injury Severity Score (3-8), with the majority of injuries being blunt (98%). Of the patients triaged green, 97% came in as direct arrivals and 94.4% were discharged from the ED after initial evaluation. As per CTS, nearly three-quarters (74%) of patients were undertriaged ‘green’ by the clinicians in a triage-naive ED. Conclusion: ​​ Three-fourths (74%) of the patients triaged green by clinicians in a secondary care hospital in Mumbai were mistriaged when retrospectively analysed using CTS. This highlights the need for implementation and evaluation of trauma triage training for the in-hospital first responders (clinicians, nurses and other paramedical staff) in the EDs.