Appropriateness of Emergency Department-based Triage for Determining Transfer of Burn Patients to a Burn Care Specialty Center

Ro,  Young Sun; Shin,  Sang Do; Kim,  Yu Jin; Park,  Ju Ok; Suh,  Gil Joon

J Korean Soc Emerg Med > Volume 18(6); 2007 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2007;18(6): 487-495.

Appropriateness of Emergency Department-based Triage for Determining Transfer of Burn Patients to a Burn Care Specialty Center

Young Sun Ro, Sang Do Shin, Yu Jin Kim, Ju Ok Park, Gil Joon Suh

¹Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. shinsangdo@snuh.org
²Department of Emergency Medicine, Jeju National University College of Medicine, Cheju, Korea.

ABSTRACT

PURPOSE:
This study was conducted to assess the appropriateness of emergency department-based triage for determining whether to transfer of burn patients to a burn care specialty center.
METHODS:
Eligible subjects were enrolled from the EDbased injury surveillance registry from April 2006 to March 2007 in a regional emergency center, which logs more than 42,000 patients annually. To assess the appropriateness of emergency department-based triage for determining whether to transfer patients to a burn center, we used the transfer guidelines recommended by the American Burn Association as the gold standard. Under-triage (defined as non-transfer of a victim who should have been transferred) and the over-triage (defined as transfer of a victim who should not have been transferred) rates were calculated.
RESULTS:
The total number of burn injury victims was 144 and the male-female ratio was 1:1.15. The mean age was 25.5+/-20.9 years. The numbers of flame, electrical, chemical, inhalation, and other burn injuries were 133 (92.4%), 2 (1.4%), 6 (4.1%), 1 (0.7%), and 2 (1.4%), respectively. Of these 144 patients, 25 (17.4%) were transferred to the ED of a burn center after triage and primary management. The others were discharged and followed up at local clinics. The numbers of major and moderate burns that were indicated for transfer to the burn center were 33 (22.9%) and 3 (2.1%), respectively. The rates of under- and over-triage were 14.6% and 6.9%.
CONCLUSION:
The proportion of inappropriate disposition of burn injury in a regional emergency center was high (21.5%). Recommended guidelines for triage of burn injuries should be applied more strictly.

Key words: Burns, Triage, Emergency department