The impact of the Trauma Triage App on prehospital trauma triage: design of a stepped-wedge, cluster randomized trial

INTERVENTION: The Trauma Triage App is a smartphone and tablet application that is a practical and quick‐to‐use user interface to a prediction model that estimates the probability that a patient is severely injured during field triage. An advice whether to transport a patient to a higher‐level trauma center or not is generated based on a pre‐defined threshold probability. CONDITION: Trauma , Undertriage, Overtriage ; ; PRIMARY OUTCOME: Undertriage, defined as the transportation of a severely injured patient (Injury Severity Score =16) transported from the scene of injury to a lower‐level trauma center. SECONDARY OUTCOME: Non‐compliance analysis of the primary outcome; overtriage, defined as the transportation of non‐severely injured patients (ISS < 16) from the scene of injury to a higher‐level trauma center; hospital length of stay; number of admissions to the Intensive Care Unit; length of stay at the Intensive Care Unit; cost‐effectiveness analysis INCLUSION CRITERIA: All patients, 18 years of age or older, with suspected moderate to severe injuries (Injury Severity Score 9 or higher), evaluated on‐scene by one of participating Emergency Medical Services that are transported to a participating emergency department.