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Research Letter
July 5, 2017

Rapid Retriage of Critically Injured Trauma Patients

Author Affiliations
  • 1Department of Surgery, St Elizabeth’s Medical Center, Boston, Massachusetts
  • 2Department of Surgery, University of California-San Francisco Benioff Children’s Hospital, Oakland, California
  • 3Department of Surgery, Regional Medical Center, San Jose, California
  • 4Department of Surgery, Stanford University School of Medicine, Stanford, California
  • 5Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
JAMA Surg. Published online July 5, 2017. doi:10.1001/jamasurg.2017.2178

Critically injured patients presenting to nontrauma hospitals require timely transfer to trauma centers1,2; however, the transfer process varies and differences in outcomes for patients from trauma centers are unknown. We evaluated regional trauma outcomes after the local Emergency Medicine System implementation of policies that allow the expedited transfer of critically injured trauma patients or “rapid retriage” from nontrauma hospitals to trauma centers. After recognizing that a patient has critical traumatic injuries, emergency department (ED) physicians at a nontrauma hospital were given the ability to call 9-1-1 to retriage the patient to an associated trauma center with an unconditional acceptance, bypassing the standard transfer process. This study sought to determine differences in outcomes among (1) critically injured ED trauma transfer patients, (2) noncritically injured ED trauma transfer patients, and (3) critically injured trauma patients presenting directly to a trauma center within a regional trauma system. We hypothesized that improved outcomes for critically injured ED trauma transfer patients would be correlated with decreased transfer times and mechanism of penetrating injury.

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