Emergency medical services (EMS) teams routinely triage patients based on the severity of their injuries. But sometimes, says a new study conducted by USF College of Public Health (COPH) researchers, that triaging can go too far. The study, “Association of mechanism of injury with overtriage of injured youth patients as trauma alerts,” was published in 2019 in the journal Trauma Surgery & Acute Care Open.

Drs. Jessica Ryan, Barbara Orban and  Etienne Pracht began the study a few years ago, when Ryan was still a PhD student at the COPH. The group focused on the issue of “overtriaging” based on mechanism of injury, which refers to how a person was injured.

“I was always interested in youth patients,” said Ryan, who is now an assistant professor at the University of West Florida. “But I got more and more focused on trauma centers and EMS after working on similar research projects with Drs. Orban and Pracht.”

Overall, the study found that motor-vehicle traffic and firearm injuries were associated with overtriage. When these unfortunate accidents happen, they are also likely to cost more because overtriaging causes more personnel to be activated at the hospital and more resources to be used.

“Overtriage is a tough thing to improve, as trauma scenes are chaotic and EMS are trained to be cautious, especially with youth,” said Ryan. “It’s easy for me to say a patient was overtriaged in hindsight, when I’m looking at patient records, but in the moment, it can be more difficult.”

Despite the difficulty of trying to address these problems, Ryan does think that the team’s findings could lead to improved EMS responses, which may ultimately save money and decrease the burden on patients who are already dealing with plenty of stress from their experience. 

“I’m currently working on a research project to train EMS in situational awareness, which I define as the identification of relevant information, comprehension of it, and then projection of outcomes, to see if we can improve triage that way,” said Ryan. “Additionally, a goal of mine is to continue building research on the differences in costs and charges between not-for-profit and for-profit hospitals and trauma centers. Lowering trauma response charges would be a great way to start lowering the overall costs for trauma patients.”

Story by Cody Brown, USF College of Public Health