Adam Rolley

Paramedic

Australia

Doctorate Title: Pre-hospital trauma triage: Epidemiology, accuracy and economics.

Doctorate Description: The burden of disease associated with severe injury in Australia is significant, and its geographic size and population dispersion challenge the trauma system response. With most major trauma patients in Australia transported by ambulance, and a lower morbidity and mortality risk if conveyed directly to a specialised trauma facility, paramedics’ ability to triage this cohort accurately is fundamental to patient outcomes. Despite this, evidence suggests triage criteria often fail to achieve the expected accuracy, with paediatrics and older people at a significantly higher risk of undertriage. Furthermore, the evidence is impacted by a moderate to high risk of bias, limited generalisability, a multitude of criteria with highly variable accuracy and a scarcity of Australian research. Given the knowledge gaps and identified limitations, contemporary research urges a greater understanding of under and overtriage, and an assessment of the economic impacts of alternative trauma triage strategies.

This work uses a person-level, linked injury dataset from Queensland to explore definitions of severe trauma and its epidemiology, the accuracy of Queensland’s current pre-hospital trauma triage criteria, alternative triage strategies and the system-level economic impacts of current and alternative criteria.