Diagnostic value of emergency medical services provider judgement in the identification of head injuries among trauma patients

Rein, Eveline A. J. van; Jochems, Denise; Lokerman, Robin D; Sluijs, Rogier van der; Houwert, Roderick M.; Lichtveld, Rob A.; Es, Michael A. van; Leenen, Luke P. H.; Heijl, Mark van

doi:10.1111/ene.13804

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Less frequent involvement of the MMT and trauma team in initial care for the elderly, might also indicate that severity of TBI in the elderly is not always recognised before admission, possibly due to a low-impact trauma mechanism such as a fall from low height. This is supported by a Dutch study that investigated diagnostic value of pre-hospital emergency medical service providers 31 . Recognition of moderate or severe TBI in mainly elderly patients before admission, could therefore be a target for improvement as well.…”

Section: Discussionmentioning

confidence: 75%

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

Jochems

Rein

Niemeijer

et al. 2021

Sci Rep

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Traumatic brain injury (TBI) is a leading cause of death and disability. Epidemiology seems to be changing. TBIs are increasingly caused by falls amongst elderly, whilst we see less polytrauma due to road traffic accidents (RTA). Data on epidemiology is essential to target prevention strategies. A nationwide retrospective cohort study was conducted. The Dutch National Trauma Database was used to identify all patients over 17 years old who were admitted to a hospital with moderate and severe TBI (AIS ≥ 3) in the Netherlands from January 2015 until December 2017. Subgroup analyses were done for the elderly and polytrauma patients. 12,295 patients were included in this study. The incidence of moderate and severe TBI was 30/100.000 person-years, 13% of whom died. Median age was 65 years and falls were the most common trauma mechanism, followed by RTAs. Amongst elderly, RTAs consisted mostly of bicycle accidents. Mortality rates were higher for elderly (18%) and polytrauma patients (24%). In this national database more elderly patients who most often sustained the injury due to a fall or an RTA were seen. Bicycle accidents were very frequent, suggesting prevention could be an important aspect in order to decrease morbidity and mortality.

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Section: Discussionmentioning

confidence: 75%

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

Jochems

Rein

Niemeijer

et al. 2021

Sci Rep

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show abstract

“…Van Rein et al [31] . aimed to determine the accuracy of prehospital care providers' judgment in identifying TBI.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…The characteristics of the eight included studies are provided in Table 2 . Included studies were all conducted in high-income countries with regionalised trauma care: United Kingdom [ 24 , 25 ], the United States of America [26][27][28][29][30] and the Netherlands [31] . All included studies were published between 2011 and 2020.…”

Section: Study Characteristicsmentioning

confidence: 99%

The diagnostic accuracy of prehospital triage tools in identifying patients with traumatic brain injury: A systematic review

Alqurashi

Alotaibi

Bell

et al. 2022

Injury

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“…Van Rein et al showed in their systematic review that almost all pre-hospital triage protocols had a low sensitivity and therefore failed to identify all severely injured patients who needed treatment in a TC [ 29 ]. Especially identifying serious neurotrauma by EMS providers has proven to be difficult; 32% of all neurotrauma and 21% of the severe neurotrauma are not recognized at the accident scene [ 30 ]. Particularly for these patients, the hospital triage may be further optimized by advanced triage tools.…”

Section: Discussionmentioning

confidence: 99%

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

Dijkink

Zwet

Krijnen

et al. 2021

Eur J Trauma Emerg Surg

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Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

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Diagnostic value of emergency medical services provider judgement in the identification of head injuries among trauma patients

Cited by 9 publications

References 30 publications

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

The diagnostic accuracy of prehospital triage tools in identifying patients with traumatic brain injury: A systematic review

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

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