Missed Application of the Field Trauma Triage Standard in Secondary Interfacility Transfers of Injury

Abstract

Introduction The Field Trauma Triage Standard (FTTS) is used to identify patients who would benefit from direct transfer to a lead trauma hospital (LTH). This study determined the frequency that patients who underwent secondary interfacility trauma transfer initially met the FTTS and assessed the delay to LTH. Methods Retrospective cohort study of all injured patients undergoing interfacility transfer to a LTH with Ornge, the provincial critical care transport organization in Ontario, Canada over a 1-year period. Frequency of missed FTTS application and delay to LTH were measured. Results A total of 460 adult interfacility transfer trauma patients were included in the study, of these 372 met FTTS (80.8%). The median time from initial hospital arrival to LTH was 5.7 hours for those patients requiring interfacility transport that initially would have met FTTS on scene. Conclusion Missed application of FTTS was overwhelming, occurring in over eighty percent of our population, contributing an average delay to definitive care of 5.7 hours. Older age was a commonly missed criterion. The addition of recreational vehicle collisions to the FTTS should be considered. The Field Trauma Triage Standard (FTTS) is used to identify patients who would benefit from direct transfer to a lead trauma hospital (LTH). This study determined the frequency that patients who underwent secondary interfacility trauma transfer initially met the FTTS and assessed the delay to LTH. Retrospective cohort study of all injured patients undergoing interfacility transfer to a LTH with Ornge, the provincial critical care transport organization in Ontario, Canada over a 1-year period. Frequency of missed FTTS application and delay to LTH were measured. A total of 460 adult interfacility transfer trauma patients were included in the study, of these 372 met FTTS (80.8%). The median time from initial hospital arrival to LTH was 5.7 hours for those patients requiring interfacility transport that initially would have met FTTS on scene. Missed application of FTTS was overwhelming, occurring in over eighty percent of our population, contributing an average delay to definitive care of 5.7 hours. Older age was a commonly missed criterion. The addition of recreational vehicle collisions to the FTTS should be considered.