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Journal of The Korean Society of Emergency Medicine 1995;6(1): 7-14. |
| A STUDY ON EMERGENCY TRANSFER SYSTEM |
| Sung Wook Choi, In Byung Kim, Han Shick Lee |
| Department of Emergency Medicine, Yonsei University Medical College |
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Published online: June 30, 1995. |
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| ABSTRACT |
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Transporting an emergent patient to a hospital has a crucial role in proper patient care. Objective of this study is to review the current methods and various patient transport system used between the hospital. We have conducted a retrospective analysis of consecutive 753 patients who was transport-in and out from emergency department of YoungDong Severance Hospital from Sep. 1, 1994 to Feb. 28, 1995. All transferred patients were divided into two large category of trauma versus non-trauma, 363 to 390 patients, respectively. Average ISS(injury severity score) for trauma patients were 7.31 point and average GCS score of 14.29 point for non trauma patients. Most of the patients were transfered-in during day and evening hours( 84 % ), but there was no peak hours for transfer-out patients. Little more than half of all transferred patients used ambulance as a mode of transportation. Among all transfer-in patients, 65% were admitted for general care, emergency operation and ICU care. Others, 17%, 18% were discharged or transfer-out to other hospital, respectively. For transfer-out patients, 72% of transfer-out patients were for admission following recommandation by an emergency physician. Each level of hospital was divided into 4 subgroup ; private clinic, small hospital, general hospital and university hospital. ISS was also divided into score less than 10 points for mild and more than 11 points for moderate to severe injury. As a results, all of patients transferred from private clinic bad less than 4 point of ISS. Where as increasing percentage of patients with higher ISS was transferred-in from higher level of hospitals. Transfer-out hospitals were carefully selected by emergency physicians according to patient health status, speciality of referring hospital and closeness to patient residence For non-traumatic patient, GCS score was divided into GCS score 14or less and 15 point. Similar to trauma patient, there was increasing percentage of patient with lower GCS score transfer-in as hospital level increase. Patients with ISS less than 10 point and GCS score 15 point can be transferredto anappropriate level of hospital if EMSS operates properly.
We suggest with a well organized EMSS, mandatory inter-hospital communication and good transfer record, proper patient transfer and treatment can be achieved.
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| Key words:
Transfer in and out, ISS, GCS, EMSS |
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