title: Automatic pre-hospital vital signs waveform and trend data capture fills quality management, triage and outcome prediction gaps.
abstract: Trauma Triage errors are frequent and costly. What happens in pre-hospital care remains anecdotal because of the dual responsibility of treatment (resuscitation and stabilization) and documentation in a time-critical environment. Continuous pre-hospital vital signs waveforms and numerical trends were automatically collected in our study. Abnormalities of pulse oximeter oxygen saturation (< 95%) and validated heart rate (> 100/min) showed better prediction of injury severity, need for immediate blood transfusion, intra-abdominal surgery, tracheal intubation and chest tube insertion than Trauma Registry data or Pre-hospital provider estimations. Automated means of data collection introduced the potential for more accurate and objective reporting of patient vital signs helping in evaluating quality of care and establishing performance indicators and benchmarks. Addition of novel and existing non-invasive monitors and waveform analyses could make the pulse oximeter the decision aid of choice to improve trauma patient triage.
authors.affiliation: National Study Center for Trauma & EMS, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Colin F
authors.initials: CF
authors.lastname: Mackenzie
authors.forename: Peter
authors.initials: P
authors.lastname: Hu
authors.forename: Ayan
authors.initials: A
authors.lastname: Sen
authors.forename: Rick
authors.initials: R
authors.lastname: Dutton
authors.forename: Steve
authors.initials: S
authors.lastname: Seebode
authors.forename: Doug
authors.initials: D
authors.lastname: Floccare
authors.forename: Tom
authors.initials: T
authors.lastname: Scalea
mesh_terms: D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014218:Triage / Q000379:methods*; D055986:Vital Signs