Aim:

To investigate the patients demographic characteristics admitted to a third level emergency unit without following the “forwarding chain protocol” and to establish the efficacy of this protocol by determining these patients emergency state.

Method:

This is a descriptive and epidemiologic study planned between 01/11/2005-31/12/2006. It included 276 patients referred to Erzurum Numune State Hospital for taking “forwarding certification” later after they admit to Ataturk University Aziziye Hospital Emergency Department (ED). Groups were analyzed by means of x2 , t and Anova tests. Statistically significance was accepted as P<0.05.

Results:

Of the patients, 67.4% were men, 62.7% were adult, 51.8% were trauma related admissions. The patients health insurances were as follows: 58% “green card” and 36.6% “social insurance foundation”. 3.3% of the patients Glascow Coma Scale (GCS) were between 9-12 and 7.6% were between 3-8. 43.1% were hospitalized, 2.5% entered intensive care unit, %2.9 died in the ED. Major complaints were motor vehicle collision (21%), angina pectoris (10.1%), stab wound (7.6%) and abdominal pain (6.9%). Main diagnoses were soft tissue injury (14.4%), fracture on the extremities (16.9%), head trauma (8%), cerebrovascular event (7.6%) and acute coroner syndrome (6.2%). Mean ages of the traumatic patients were significantly lower (26.8±16 vs. 40.5±24.5; P=0.000) and mean GCS were significantly higher (14.5±2 vs 13.5±3.3; P=0.000) than non-traumatic patients. Busy hours were between 14:00-22:00. Males proportion increased up to 79% between 12:01-17:59.

Conclusion:

As patients who admit to a third level ED without following the “forwarding chain protocol” discussed with total emergency admittances, they had included more trauma victims, and hospitalization and mortality rates had been higher.

Keywords: Forwarding Chain Protocol, Emergency medicine