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Master Thesis

Accuracy of the field triage protocol for severe trauma patients due to winter sliding sports within the northern French Alps trauma system (TRENAU)

Abstract : Introduction: Prehospital triage for the recognition of severe trauma patients is the cornerstone of a trauma system. This triage within the regional trauma system of the RENAU in the French Alps, seems less effective in the recognition of severe trauma in the event of an accident of winter sports sliding (alpine skiing, snowboarding, ski touring). Study design: A retrospective analysis of all severe traumatic injuries included in the RENAU database from 2012 to 2018 is performed. These critically injured patients were classified into two groups according to the nature of the accident. On the one hand the victims of winter sports sliding (WSS) and on the other hand all other accidents. Undertriage rate was defined as the proportion of severely injured patients (ISS≥16) who were transported to a Level 3 trauma center; and vice versa for overtriage. The interhospital transfer rate as well as the prehospital gradation according to the RENAU prehospital triage protocol were analyzed. An analysis of the lesions presented by the traumatized WSS was carried out. Results: A total of 8052 patients were registered in the RENAU database during this period. After application of the exclusion criteria, the analysis involved 7872 patients including 1342 (17%) severely traumatized WSS. Undertriage of patients with WSS injuries was higher than in the group of other accidents with a rate of 10.9% vs. 6.5% (p = 0.001). Overtriage rate was not significantly different (43.2% vs. 45.1%, p = 0.2). The prehospital gradation according to the RENAU field triage was carried out in 48.8% in the group of accident victims of the WSS and in 62.6% in the group of other accidents (p = 0.001). Among the trauma patients due to WSS accident, there is a higher rate of trauma in the abdominopelvic territory compared with other types of accidents (20.3% vs 12.1% p = 0.001). Conclusion: Undertriage rate is higher in the event of an WSS accident than the other accidents. This rate is mainly influenced by the high proportion of prehospital patients who are not graded according to the RENAU triage algorithm in the event of an WSS accident. As a consequence, there is an increase in the number of inter-hospital transfers in these patients. The presence of a high rate of abdominal and pelvic lesions in this group could also have an influence in this rate.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03187175
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Submitted on : Wednesday, March 31, 2021 - 5:27:00 PM
Last modification on : Saturday, April 3, 2021 - 3:17:30 AM
Long-term archiving on: : Thursday, July 1, 2021 - 7:02:59 PM

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  • HAL Id : dumas-03187175, version 1

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Florent Cheminal. Accuracy of the field triage protocol for severe trauma patients due to winter sliding sports within the northern French Alps trauma system (TRENAU). Human health and pathology. 2020. ⟨dumas-03187175⟩

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