Which hospital? The importance of field triage

Different factor needs to be taken into account in the decision about the appropriate hospital for the road traffic victim such as type of injuries, services available at the hospital, comparative distances and times to reach hospitals, and regulations concerning the transport of injured people.

Triage is the term applied to the process of classifying patients at the scene according to the severity of their injuries to determine how quickly they need care. Careful triage is needed to ensure that resources available in a community are properly matched to each victim's needs. Formal algorithms or protocols need to be developed to ensure that community resources are used properly to care for trauma patients; these algorithms must exist for both the pre-hospital and hospital setting. Failure to develop protocols may lead to over-triage or under-triage. Over-triage occurs when non-critical patients are sent to facilities offering the highest level of care. Under-triage occurs when critically injured patients are treated at the local level or sent to facilities that are not properly equipped to meet their needs. This may result in increased morbidity and mortality among patients with otherwise treatable injuries [50].