Background: Priority grade assessment according to urgency level of the patients (triage) is considered vital in\r\nemergency medicine casualties. Little is known of the experiences of pre-hospital emergency medicine triage\r\nperformed by General Practitioners (GPs) in the community. In this study we bring such experiences from a Norwegian\r\nisland community, with special emphasis on over- and undertriage.\r\nMethods: In the island municipality of Austevoll, Western Norway, where the GPs and the ambulance services both\r\ntake part in all medical emergency cases, all these cases were recorded during a 2-year period (2005ââ?¬â??2007). We\r\ncompared the triage of the patients at the stage of the telephone reception of the incident, and the subsequent\r\nrevision of the triage at the first personal examination of the patient.\r\nResults: 236 emergency medical events were recorded, comprising 240 patients. Of these, 42% were\r\ndowngraded between the stages (i.e. initially overtriaged), 11% were upgraded (i.e. initially undertriaged) and\r\n47% remained in unchanged priority group. Of the diagnostic groups, acute abdominal cases had the highest\r\nprobability of being upgraded between stages, while the aggregated diagnostic group of syncopes, seizures,\r\nintoxications and traumas had the highest probability of being downgraded. The principal reason for upgrading\r\nwas lack of necessary information at the stage of call. In a minority of cases the upgrading was due to real\r\npatient deterioration between stages.\r\nConclusions: In pre-hospital triage of emergency patients, downgrading happens between notification of\r\nevents and actual patient examination in a substantial proportion. Upgradings of cases are considerably fewer,\r\nbut the potential serious implications of upgrading warrants individual scrutiny of such cases
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