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Trauma destination legislation

Martyn Hodson trauma-list@trauma.org
Mon, 7 Apr 2003 12:00:20 +0100


----- Original Message -----
From: avir@bgumail.bgu.ac.il
To: trauma-list@trauma.org
Sent: Monday, April 07, 2003 11:35 AM
Subject: Re: Re: Trauma destination legislation


Ken,

I think that overtriage is a serious medical, not political economic,
problem.  Overtriage will cause death, by overwhelming the facilities. There
is even hard data to prove this.

<MH> this only depends on how the traige process is applied - if the over
traige is in the prehospital phase  the nthe risk of overloading the system
is t omy mind minimised ad the  differences are  minimal 9 unless of course
the trauma recieving facility is a some distance away and it tiesup ambi and
crew for a considerably longer period of time.

If the paient is re-triaged at the appropriate stage ( on arrival to the
recieving facility , on completion of the secondary survey...) then  there
is a reduced risk of the service being overwhelmed, this of course assumes
that  trauam recieving hospitals are not over scarce
 </MH>

It is a medical problem since patients are harmed by being over triaged, and
because triage is part of the medical decision making process

</MH> patients themselves are not harmed by over triage - this is the basic
premise of telephone triage systems in primary care and ED environments -
that this stage overtriages and the face to face encounter ensuing can
better allocate the correct priority. what is harmed by over triage is the
service delivery if resources are substantially over stretched.



Martyn