Triage Prehospital EMS and Medical Care
AJTES Volume 8, Number 2, July 2024
Zeqiri A, et al. - Triage Preshospital EMS and Medical Care.

Keywords

Triage
Triage system
prehospital
EMS
training
education

How to Cite

Zeqiri, A., Lenjani, B., Zeka, B., Lenjani, D., Lenjani, I., & Dogjani, A. (2024). Triage Prehospital EMS and Medical Care. Albanian Journal of Trauma and Emergency Surgery, 8(2), 1419-1424. https://doi.org/10.32391/ajtes.v8i2.411

Abstract

Introduction: Prehospital emergency medical services (EMS) are essential to emergency medical care. They provide emergency assessment and treatment for seriously ill or injured patients and transport them by ambulance to an emergency department. Adopting triage methods for systematically prioritizing patients according to how urgent patients need care, including Triage of requests for acute medical treatment, is a promising development in our healthcare system. In Kosovo, there is a gap between the effects of prehospital triage systems and the impact of using the same triage system in two or more EMS settings. In this quality improvement study, implementing the TT app intervention was associated with higher rates of inefficient Triage in prehospital settings. However, supporting EMS professionals in their decision-making by calculating the probability of an individual patient needing specialized care at the scene of injury is a new and promising approach to optimize Triage in the field. If we can fully realize the potential of this approach, it could significantly improve the efficiency and effectiveness of our emergency medical care, leading to better patient outcomes. Standards and most health professionals need to be educated and trained in this critical component of EMS. Education, education, and training for the three levels of health care should be an obligatory component to enhance the quality of emergency medical care for children and adults at risk. It is high time to develop and test a conceptual triage scheme or model that will rely on a triage system that responds to the conditions of our health system. Develop clinical guidelines, algorithms, and triage protocols at the three levels of health care. All healthcare professionals must be educated and trained in ongoing coaching, communication courses, BLS AED, Pediatric, PHTLS, Adult Advanced Life Support, ATLS, and International Trauma Life Support.

Conclusion: Triage is vital in optimizing patient outcomes in the high-pressure EMS world. It is the process of rapidly assessing a patient's condition to determine the urgency of care and the most appropriate destination for definitive treatment. Done effectively, prehospital Triage ensures that patients receive the right level of care at the right time, maximizing their chances of survival and minimizing long-term complications.

 

https://doi.org/10.32391/ajtes.v8i2.411
Zeqiri A, et al. - Triage Preshospital EMS and Medical Care.

References

Geiderman, J. M., Malik, S., McCarthy, J. J., & Jagoda, A. (2018). The care of VIPs in the emergency department: Triage, treatment and ethics. American Journal of Emergency Medicine. https://doi.org/10.1016/j.ajem.2018.07.009

Yancey CC, O'Rourke MC. Emergency Department Triage. [Updated 2023 August 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557583/

Ingeborg Beate Lidal, Hilde H Holte and Gunn Elisabeth Vist Triage systems for prehospital emergency medical services - a systematic review Lidal et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:28 http: //www. sjtrem. Com/content /21/1/28.

Adida,E., H. Mamani, S. Nassiri. 2016. Bundled payment vs. fee-for-service: Impact of payment scheme on performance. Management Sci. 63(5): 1606–1624.

Seokjun Youn, H. Neil Geismar, Michael Pinedo, Planning and scheduling in healthcare for better care coordination: Current understanding, trending topics, and future opportunities, Production, and Operations Management, 10.1111/poms.13867, 31, 12, (4407–4423), (2022).

Lenjani, B., Baftiu, N., Krasniqi, B., Makolli, S., Lenjani, D., Mišanović, V., Ljuhar, K., & Dogjani, A. (2023). Access and Emergency Medical Care for Massive or Multiple Injuries. Albanian Journal of Trauma and Emergency Surgery, 7(1), 1181-1188. https://doi.org/10.32391/ajtes.v7i1.298

Helm J. E., Alaeddini A., Stauffer J. M., Bretthauer K. M., Skolarus T. A. 2016. Reducing hospital readmissions by integrating empirical prediction with resource optimization. Prod. Oper. Manag. 25(2): 233–257.

Webb, E. M., & Mills, A. F. (2019). Incentive–Compatible Prehospital Triage in Emergency Medical Services. Production and Operations Management, 28(9), 2221 2241. https://doi.org/10.1111/poms.13036

Andritsos, D. A., C. S. Tang. 2018. Incentive programs for reducing readmissions when patient care is co-produced. Prod. Oper. Manag. 27(6): 999–1020.

Carroll, G., K. Levy, R. Pescatore, R. Hong. 2019. Examination of EMS decision-making in determining the suitability of patient diversion to urgent care centers. Healthcare, vol. 7. Multidisciplinary Digital Publishing Institute, 24.

Mills, A. F., J. E. Helm, A. F. Jola-Sanchez, M. V.Tatikonda, B.A.Courtney. (2018). Coordination of autonomous healthcare entities: Emergency response to multiple casualty incidents. Prod. Oper. Manag. 27(1): 184–205.

Sun Z., Argon N. T., Ziya S. 2017. Patient triage and prioritization under austere conditions. Management Sci. 64(10): 4471–4489.

Saghafian S., Hopp W. J., Iravani S. M., Cheng Y., Diermeier D. 2018. Workload management in telemedical physician triage and other knowledge‐based service systems. Management Sci. 64(11): 5180–5197.

Robin D. et al. Accuracy of Prehospital Triage of Adult Patients With Traumatic Injuries Following Implementation of a Trauma Triage Intervention

Bhattarai, H. K., Bhusal, S., Barone-Adesi, F., & Hubloue, I. (2023). Prehospital Emergency Care in Low- and Middle-Income Countries: A Systematic Review. Prehospital and disaster medicine, 38(4), 495–512. https://doi.org/10.1017/S1049023X23006088

Agron Dogjani, & Kastriot Haxhirexha. (2021). MBËSHTETJA BAZIKE JETËSORE DHE DEFIBRILIMI. (p. 178). Botimet M & B. https://doi.org/10.5281/zenodo.5484293

Cimino, J., & Braun, C. (2023). Clinical Research in Prehospital Care: Current and Future Challenges. Clinics and practice, 13(5), 1266–1285. https://doi.org/10.3390/clinpract13050114

Dogjani, A., Haxhirexha, K., Gjata, A., & Subashi, K. (2023). Initial Assessment of Trauma Patients. Albanian Journal of Trauma and Emergency Surgery, 7(2.7), 25. https://doi.org/10.32391/ajtes.v7i2.7.365

Bäckström, D., Alvinius, A. Physicians’ challenges when working in the prehospital environment - a qualitative study using grounded theory. Int J Emerg Med 17, 28 (2024). https://doi.org/10.1186/s12245-024-00599-0

Xu K., Chan C. W. (2016). Using future information to reduce waiting times in the emergency department via diversion. Manuf. Serv. Oper. Manag. 18(3): 314–331.

Newgard CD, Fischer PE, Gestring M, et al. Writing Group for the 2021 National Expert Panel on Field Triage. National guideline for the field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2021. J Trauma Acute Care Surg. 2022;93(2):e49-e60

Basri Lenjani First Aid CPR-AED in emergency P23:145 2023. https://doi.org/10.5281/zenodo.5510559

Kim, K., & Oh, B. (2023). Prehospital triage in emergency medical services system: A scoping review. International Emergency Nursing. https://doi.org/10.1016/j.ienj.2023.101293

Van Rein EAJ, van der Sluijs R, Houwert RM, et al. Effectiveness of prehospital trauma triage systems in selecting severely injured patients: is comparative analysis possible? Am J Emerg Med. 2018;36(6):1060-1069.

Triage, Treatment, and Transport Guidelines (T3G) As Recommended by the Bureau of EMS and Trauma System. Arizona Department of Health Services pp. 12-23, September 21, 2023.

Kisook Kim Prehospital triage in emergency medical services system: A scoping review Pub Med. 2023.

Dogjani, A., Gjata, A., Haxhirexha, K., Blloshmi, A., Shandro, S., & Laqja, S. (2020). Advanced Trauma Life Support training. How useful is it? Albanian Journal of Trauma and Emergency Surgery, 4(2.4), 28–29. https://doi.org/10.32391/ajtes.v4i2.4.171

Dogjani, A., Haxhirexha, K., Gjata, A., & Subashi, K. (2023). The ATLS® Course: Empowering Healthcare Professionals for Excellence in Trauma Care. Albanian Journal of Trauma and Emergency Surgery, 7(2), 1221-1223. https://doi.org/10.32391/ajtes.v7i2.350

Cobianchi, L., Dal Mas, F., Agnoletti, V. et al. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey. World J Emerg Surg 18, 14 (2023). https://doi.org/10.1186/s13017-022-00464-6

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