Original Title: Portrait québécois du triage préhospitalier en traumatologie (2013-2023) - Évaluation de l’implantation de l’échelle québécoise de triage préhospitalier en traumatologie (EQTPT)

Authors' objectives: With the objective of evaluating and updating the EQTPT, the Ministère de la Santé et des Services sociaux (MSSS) mandated INESSS to provide an overview of its use, outcomes, and challenges encountered in Québec’s regions since the deployment of the EQTPT, as well as to contextualize these findings using the scientific literature.

Authors' results and conclusions: RESULTS (#1 CHANGES IN THE PROFILE OF TRAUMA PATIENTS TRANSPORTED BY AMBULANCE IN QUÉBEC): Among patients transported by ambulance, the proportion who sustained severe injuries (defined as ISS > 15, calculated using hospital data) increased slightly from 2013-2014 to 2022-2023 (from 11.6% to 13.2%), particularly among males. Approximately two out of three severely injured patients were male overall. (#2 DOCUMENTATION OF THE EQTPT REMAINS LOW ACROSS QUÉBEC): Several barriers and facilitators related to EQTPT documentation were identified, highlighting the need for training and frequent reminders. The complexity of the EQTPT and a lack of clarity for some of the criteria were also reported as obstacles. (#3 NEARLY HALF OF TRAUMA PATIENTS WERE TRIAGED AT STEP 4 ): Among patients triaged using one of the five EQTPT steps, 41.8% were triaged at step 4. Slightly more than one-third of patients were triaged at steps 1 (14.1%), 2 (8.4%), and 3 (15.6%), while approximately 20.0% were triaged at step 5. (#4 EQTPT CRITERIA IDENTIFY THE MAJORITY OF SEVERELY INJURED PATIENTS): The criteria at steps 1 to 3 are less effective at identifying older patients with severe injuries. Fewer than one-third (32.5%) of severely injured patients aged 65 years and older were triaged at steps 1 to 3, whereas three-quarters (75.1%) of severely injured patients aged 64 years and younger were triaged at these steps. (#5 LIMITED DATA ARE AVAILABLE TO SET THE MAXIMUM TIME TO BE SPENT BYPASSING LOWER-LEVEL TRAUMA CENTRES): Among patients triaged at steps 1 to 3 and transported directly to the definitive care facility where care was provided (n = 7,223), the median transport time was 19 minutes (Q1-Q3: 10 to 32 minutes), and 97.1% of these ambulance transports were completed within 60 minutes or less. (#6 THE EQTPT APPEARS TO DIRECT A SUBSTANTIAL PROPORTION OF TRAUMA PATIENTS TO THE APPROPRIATE LEVEL OF TRAUMA CENTRE): From 2013-2014 to 2022-2023, the proportion of severely injured patients directed to high-level trauma centres increased (from 42.9% to 47.7%), while the proportion of patients with minor injuries directed to high-level trauma centres remained stable at approximately 28%. (#7 A SMALL PROPORTION OF PATIENTS WITH SIGNIFICANT TRAUMATIC INJURIES WERE ADMITTED TO FACILITIES WITHOUT A TRAUMA DESIGNATION): Within this patient group, the proportions of men and women, often older, were similar. Injuries were mainly related to falls, and fractures were the predominant diagnoses. CONCLUSION: Although prehospital triage following the implementation of the EQTPT appears appropriate for most trauma patients, several improvements could nonetheless be made. The present evaluation identifies a number of elements that should be considered for an eventual update of the EQTPT. In particular, certain criteria could be added or clarified to improve the triage of specific patient groups (older adults, patients on anticoagulant therapy, and victims of falls), to reduce subjective interpretation of some criteria, and to facilitate decision-making by paramedics.

Authors' methods: The portrait of prehospital triage of trauma patients using the EQTPT was produced using descriptive statistics to describe patient profiles (e.g., age, sex, mechanisms, types and severity of injuries), the rate of EQTPT documentation, patient triage according to EQTPT step, and prehospital time, as well as destination hospitals and patient care pathways. Prehospital triage of trauma patients using the EQTPT was reported according to the step recorded by paramedics in the prehospital record. Injury severity was assessed using the Injury Severity Score (ISS).

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/portrait-quebecois-du-triage-prehospitalier-en-traumatologie-2013-2023.html

Year Published: 2026

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Traumatologie/Portrait_EQTPT_EP_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)