Adult trauma prehospital evaluation: Old or new scores?

Gojković, Zoran; Jokšić-Mazinjanin, Radojka; Vasović, Velibor; Smieško, Gordana; Šaponja, Predrag; Petrović, Radmila; Jokšić-Zelić, Milena; Saravolac, Siniša; Mikov, Momir

doi:10.5937/tmg1901031g

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…Pri sekundarnoj trijaži, koordinator trijaže bi trebao da se osloni i na anatomsku komponentu, koja takođe može da utiče na odluku o redosledu transporta povređenih do bolnice. Mogu se koristiti i različiti trauma skorovi za zbrinjavanje pojedinačnih povređenih kako bi se olakšala komunikacija sa lekarima u prijemnim ambulantama (27). Preživljavanje pacijenata u slučaju teške traume zavisi od vrednosti vitalnih parametara i anatomskih povreda, ali i od preduzetih mera zbrinjavanja koje imaju za cilj da stabilizuju stanje pacijenta (28).…”

Section: Pregledni Rad/reviewunclassified

Prehospital care of injured patients in a mass casualty incidents

Jokšić-Mazinjanin,

Bjelić,

Jakšić

et al. 2023

ABC - čas urg medicine

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Mass accidents do not happen often, but when they do, they cause a significant disruption in the functioning of a society with a large number of casualties and an increased percentage of deaths among the injured. The aim of the work is to present the way of organization within the emergency medical aid service in the event of a mass accident. Numerous services are involved in caring for the injured, so their mutual cooperation is important, as is the functioning within each service. Depending on the type of event, the leader of the intervention should be from the service that is responsible for the nature of the event. He is in charge of organizing the entire intervention. All the services that participate in care have their own leader who communicates with the leader of the intervention. Within the Emergency Medical Service, the triage leader and the transport leader play an important role. The triage leader is in charge of primary triage. It uses simple triage algorithms to triage the injured according to the urgency of care in four categories in the shortest possible time. After primary triage, secondary triage and treatment of the injured is in process. Only necessary measures to stabilize the injured are taken during this phase. The transport of the injured takes place based on the priority and the type of transport that is needed. During the whole treatment process, the injured must be marked with triage cards. Based on them,we can later conduct the documentation: total number of injured, number of injured by triage categories, care measures taken, method and time of transport. In order for the services to provide the best care for injured in a mass accident, the existence of unique protocols at the level of one country is necessary. In addition to protocols, education and training of employees are necessary, not only in the emergency medical service, but in all services that participate in caring for the injured. Best way to do this is shared training of employees from several departments. Only in this way can the available resources be used in the most optimal way to take care of the largest number of injured people in the best possible way and in the shortest possible time.

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Section: Pregledni Rad/reviewunclassified

Prehospital care of injured patients in a mass casualty incidents

Jokšić-Mazinjanin,

Bjelić,

Jakšić

et al. 2023

ABC - čas urg medicine

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“…By using trauma scoring systems, it is possible to identify patients with critical trauma severity and alert all parts of the health system. The ultimate goal should be to improve trauma management and increase survival rates in patients with critical trauma [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes

et al. 2023

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Introduction: Trauma scoring systems in prehospital settings are supposed to ensure the most appropriate in-hospital treatment of the injured. Aim of the study: To determine the sensitivity and specificity of the CRAMS scale (circulation, respiration, abdomen, motor and speech), RTS score (revised trauma score), MGAP (mechanism, Glasgow Coma Scale, age, arterial pressure) and GAP (Glasgow Coma Scale, age, arterial pressure) scoring systems in prehospital settings in order to evaluate trauma severity and to predict the outcome. Materials and Methods: A prospective, observational study was conducted. For every trauma patient, a questionnaire was initially filled in by a prehospital doctor and these data were subsequently collected by the hospital. Results: The study included 307 trauma patients with an average age of 51.7 ± 20.9. Based on the ISS (injury severity score), severe trauma was diagnosed in 50 (16.3%) patients. MGAP had the best sensitivity/specificity ratio when the obtained values indicated severe trauma. The sensitivity and specificity were 93.4 and 62.0%, respectively, for an MGAP value of 22. MGAP and GAP were strongly correlated with each other and were statistically significant in predicting the outcome of treatment (OR 2.23; 95% Cl 1.06–4.70; p = 0.035). With a rise of one in the MGAP score value, the probability of survival increases 2.2 times. Conclusion: MGAP and GAP, in prehospital settings, had higher sensitivity and specificity when identifying patients with a severe trauma and predicting an unfavorable outcome than other scoring systems.

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The application of the Kampala trauma Score for prehospital assessment of severity of injuries and prediction of outcome after severe trauma

Milivojčević-Bevc,

Tasić-Uroš,

Anđelić

et al. 2023

Halo 194

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Severe trauma is the main cause of mortality and disability in modern society. Emergency medical doctors are usually the first to establish contact with the injured person, and the extent of definitive care largely depends on their correct assessment of the severity of the injury, using an adequate pre-hospital trauma score. Injury severity scores are used to numerically categorize the type and extent of the injury. They represent an important additional instrument, which is used to enable faster triage, the categorization of injury severity, adequate care, treatment, and transport of patients with multiple injuries to the appropriate hospital. They are also important in research. This paper aims to suggest, using several case reports, the possibility of pre-hospital use of the Kampala Trauma Score (KTS) as an easily applicable and very suitable system for monitoring the condition and predicting the outcome of seriously injured patients. The patients were primarily assessed at the pre-hospital level and assigned a certain injury severity score according to the KTS, which later proved to reflect their definitive outcome. It can be concluded that the KTS is an effective scoring system that can be used during initial triage of the seriously injured for categorization of the severity of the injury, prediction of mortality and necessity of hospitalization. The possibility of its potential application during emergency care of the seriously injured, both for differentiating the severity of injuries and for predicting the definitive outcome, is indicated. However, due to the limited number of patients, original research should be conducted on a larger sample.

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Adult trauma prehospital evaluation: Old or new scores?

Cited by 3 publications

References 26 publications

Prehospital care of injured patients in a mass casualty incidents

Prehospital care of injured patients in a mass casualty incidents

Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes

The application of the Kampala trauma Score for prehospital assessment of severity of injuries and prediction of outcome after severe trauma

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