Optimizing prehospital triage: Web‐based tools for severity classification in prehospital care, prospective study in Northern Thailand

Abstract Background Emergency medical services act as the frontline in patient care. They triage patients' severity and initial treatment and refer them to the proper hospital. Incorrect triage can lead to adverse outcomes. Objective The study's main objective is to examine the agreement between the prehospital triage level and the emergency department (ED) triage level in the same patients. The secondary outcome is to predict admission. Methods A prospective study was performed. The severity of triage levels at the scene was determined by the Advanced Life Support (ALS) team using the Chiang Mai University (CMU) prehospital triage webpage. Then they were compared with the initial Canadian Triage and Acuity Scale (CTAS) level at the ED using kappa correlation. This study was performed from April 1 to August 31, 2023. Admissions were predicted utilizing the CMU prehospital triage webpage. The data were analyzed for sensitivity and specificity. Results The analysis included 176 patients who were triaged by the ALS team. There was a fair agreement between the scene triage by CMU prehospital triage webpage and ED triage by CTAS (kappa = 0.391, 95% CI = 0.309–0.479, p ‐value < 0.005). The CMU prehospital triage webpage predicted 73.79% of admissions (95% CI = 64.20–81.96) and 71.23% specificity (95% CI = 59.45–81.23). Conclusion There was a fair agreement between the scene triage by CMU prehospital triage webpage and ED triage by CTAS. However, the CMU prehospital triage webpage has good sensitivity and specificity for predicting admission.