Revised Trauma Score 기준 병원 전 중증외상환자의 119구급대원 과소분류 요인 분석
Factors associated with undertriage of prehospital major trauma patients by 119 emergency medical technician based on the revised trauma score
Purpose: This study aimed to analyze undertriage occurring during prehospital trauma triage by comparing paramedic assessments of major trauma with the Revised Trauma Score (RTS) criteria and identifying factors associated with undertriage. Methods: This retrospective observational study analyzed the prehospital care reports of 23,030 trauma patients transported by 119 emergency medical services (EMS) in a single province between February 1, 2024, and January 31, 2025. Among these patients, 380 with RTS <7 were defined as having RTS-defined major trauma and included in the final analysis. Cases in which 119 EMT classified the RTS-defined major trauma patients as non-major were defined as under-triage, whereas cases classified as major were considered triage concordance with the RTS-based classification. Cross-tabulation analyses were conducted using general and clinical characteristics, primary injury site, and mechanism of injury as variables, followed by univariate logistic regression analysis. Results: Decreased systolic blood pressure and oxygen saturation were significantly associated with a lower likelihood of undertriage. In contrast, age ≥80 years and injury mechanisms, such as falls and slips, were significantly associated with an increased likelihood of undertriage. Conclusion: Prehospital triage criteria should be refined for trauma patients aged ≥80 years and for injury mechanisms involving falls or slips. Careful attention is required to avoid underestimating the likelihood of major trauma in elderly patients with fall-related injuries, even when their vital signs are within the normal range.
목차
= Abstract = Ⅰ. 서론 1. 연구의 필요성 2. 연구의 목적 Ⅱ. 연구방법 1. 연구설계 2. 연구대상 3. 연구도구 4. 연구윤리 5. 자료수집 6. 분석방법 Ⅲ. 연구결과 1. 과소분류군과 판정일치군의 일반적특성의 차이 2. 과소분류군과 판정일치군의 임상적특성의 차이 3. 과소분류군과 판정일치군의 주외상부위 및 손상기전의 차이 4. 과소분류와 유의한 연관성을 보인 변수에 대한 단변량 로지스틱 회귀분석 Ⅳ. 고찰 Ⅴ. 결론 및 제언 1. 결론 2. 제언 References
키워드
Major trauma119 EMTPrehospital triageRTSUndertriage
저자
김주희 [ Ju-hee Kim | 충청남도 공주소방서 구급대원 ]
이경열 [ Kyoung-Youl Lee | 국립공주대학교 응급구조학과 교수 ]
Corresponding Author
한국응급구조학회 [The Korean Society of Emergency Medical Technology]
설립연도
1997
분야
의약학>응급의학
소개
복합 구조적인 산업사회의 발전에 따라 안전사고와 응급상황에서의 구조구급요청자들이 증가하고 있으나 우리나라의 응급의료체계는 아직 그 수준을 따라가지 못하고 있는 실정이다. 이에 우리나라의 응급의료체계를 확립하고 구조구급에 관한 기초학문의 발전에 기여하고자 학회를 창립한다.
간행물
간행물명
한국응급구조학회지(구 한국응급구조학회논문지) [The Korean Journal of Emergency Medical Services ]