Prehospital Triage

Introduction

RETTS triage is a system that is widely used in emergency care in Sweden. The RETTS triage contains a reason for visit, a set of vital parameters and a 'colour' based on a calculation of the included vital paramters. The colour indicates a priority based on the severity of the patient condition. The colours are often linked to time for how soon a patient should be cared for. The colours included in a RETTS triage in the order of priority are:

  1. Red
  2. Orange
  3. yellow
  4. Green
  5. Blue

To create a RETTS Triage in COSMIC the resource ClinicalImpression is used. The ClinicalImpression is the main model for the triage but the triage can also include vital parameters. This can be solved in two ways: • Use of a bundle in which both ClinicalImpression and Observation resources for the vital parameters are included. The ClinicalImpression should then include references to the observations. • Use of a ClinicalImpression resource which holds the observations as contained resources. Compliance with Cambio profiles for both Bundle, ClinicalImpression and Observations is needed.

The following seven simple physiological parameters are included in the Triage:

  • Respiratory rate
  • Oxygen saturations
  • Body Temperature
  • Blood pressure
  • Heart rate
  • Level of consciousness(ACVPU)
  • Air Passage

Included Profiles

  • ClinicalImpressionTriageRetts - Use case profile for communicating triage data of a patient between a prehospital system and COSMIC. Concerns triages calculated using the RETTS triage protocol. The profile includes, triage level, vital signs, and reason for visit, contextuel data and meta data.

  • ObservationAirPassageLite - communicates an air passage observation of a patient with any of the values Clear, Threatened or Obstructed.

  • ObservationAcvpuLite - communicates an ACVPU observation of a patient with any of the values Alert, Confusion, Voice, Pain or Unresponsive.

  • ObservationOxygenSaturationLite Communicates the oxygen saturation of a patient in percentage.

  • ObservationBodyTemperatureLite - communicates a patient's body temperature in °C.

  • ObservationBPLite - communicates a patient's systolic and diastolic blood pressure.

  • ObservationHeartRateLite - communicates a patient's heart rate in beats per minute.

  • ObservationRespiratoryRateLite - communicates respiratory rate of a patient in breaths per minute.

  • BundleTriage - The BundleTriage profile may be used as a container for sending a triage to COSMIC. The bundle contains a ClinicalImpression entry but may also contain other resource entries referenced from the ClinicalImpression.

Bundle:

If a bundle is used to send the RETTS Triage and included vital paremeters the following bundle profile is used:

  • BundleNews2 - The BundleTriage profile may be used as a container for sending a RETTS triage and the vital signs used to calculate the triage to COSMIC. The bundle should contain all vital sign profiles used for calculationg a triage as well as the clinicalImpressionTriageRetts profile.

Use Cases

Create Triage for Patient

Invalidate Triage for Patient