Do Prehospital Trauma Center Triage Criteria Identify Major Trauma Victims?
Archives of SurgeryPublished 1 February 1995
Thomas J. Esposito
Citations175
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TL;DR
A limited set of high-yield prehospital criteria are acceptable indicators of MTV and isolated low- and intermediate-y yield criteria may not be useful for initiating trauma center triage or full activation of hospital trauma teams.
Abstract
A limited set of high-yield prehospital criteria are acceptable indicators of MTV. Isolated low- and intermediate-yield criteria may not be useful for initiating trauma center triage or full activation of hospital trauma teams.
Keywords
Medicine
The American Journal of SurgeryAccuracy and relationship of mechanisms of injury, trauma score, and injury severity score in identifying major trauma
142 Citations1986William B. Long, Ben L. Bachulis +1 more
The accuracy of mechanism of injury criteria and trauma scores as triage criteria for identifying major trauma patients has been determined from the experience at one trauma center treating 2,500 patients over a 2 year period.
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The ISS may not be completely correlated with the resource requirements of injured patients and should not be used as the sole means by which to define major injury.
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110 Citations1988Robert Knopp, Ann Yanagi +3 more
The purpose of this study was to assess the predictive value of specific MOI and AI in detecting critically injured trauma victims (Injury Severity Score [ISS] of more than 15) and determine the best combination of TS, MOI, and AI that produced the lowest percentage of undertriage and overtriage.
Annals of Emergency MedicineThe failure of prehospital trauma prediction rules to classify trauma patients accurately
99 Citations1989William G. Baxt, Charles C. Berry +2 more
The results suggest that the usefulness of existing prehospital trauma predictive rules must be questioned, because not one of the rules was able accurately to identify surviving patients who had sustained major injuries.
The Journal of Trauma: Injury, Infection, and Critical CareA Method for Evaluating Field Triage Criteria
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An approach is suggested for evaluating the balance between over- and undertriage that occurs for a given set of triage criteria and triage guidelines can be modified to meet regional triage objectives.
The Journal of Trauma: Injury, Infection, and Critical CareThe Utility of Physiological Status, Injury Site, and Injury Mechanism in Identifying Patients with Major Trauma
92 Citations1988Eric M. Cottington, Joseph C. Young +4 more
The influence of physiologic, injury site, and injury mechanism criteria on the diagnosis of major trauma in 2,057 trauma patients was examined and a set of triage guidelines was developed.
The Journal of Trauma: Injury, Infection, and Critical CareImproving the Field Triage of Major Trauma Victims
92 Citations1988Peggy Knudson, Christy Frecceri +1 more
The addition of mechanisms of injury to standard field triage scoring appears to improve the identification of seriously injured patients while retaining an acceptable level of overtriage.
The Journal of Trauma: Injury, Infection, and Critical CareEmpirical Development and Evaluation of Prehospital Trauma Triage Instruments
91 Citations1985GLENN KANE, Rita Engelhardt +6 more
This study appears to be the first to use multivariate analysis to systematically design a field triage instrument and to evaluate its performance in terms of a meaningful and plausible criterion for which patients ought to be treated at trauma centers.
The Journal of Trauma: Injury, Infection, and Critical CareOPTIMIZING PREHOSPITAL TRIAGE CRITERIA FOR TRAUMA TEAM ALERTS
89 Citations1993Judith A. Phillips, Timothy G. Buchman
A tool that, during the prehospital phase, can sort inner-city trauma victims into those who will require ICU/OR services and those who would not, and may represent an important strategy for more effective distribution of increasingly scarce and costly resources.
Archives of SurgeryWhy Surgeons Prefer Not to Care for Trauma Patients
89 Citations1991Thomas J. Esposito
The most significant influence on preference not to treat trauma patients was exerted by the perception of a negative impact on practice, older age, and perception of increased medicolegal risk.
JAMAThe Trauma Score as a Triage Tool in the Prehospital Setting
84 Citations1986John A. Morris
The Trauma Score was prospectively tested as a field triage tool and its accuracy against that of the Injury Severity Score (ISS), calculated after the patients' injuries were fully defined.
The American Journal of SurgeryEvaluation of injury mechanism as a criterion in trauma triage
83 Citations1986Daniel Lowe, George R. Oh +2 more
Injury mechanism as a primary trauma triage criterion is an acceptable means of identification of potential injury for transport to a trauma facility.
Annals of Emergency MedicineIneffectiveness of the trauma score and the CRAMS scale for accurately triaging patients to trauma centers
79 Citations1985Joseph P. Ornato, Edward J Mlinek +2 more
Paramedics' qualitative judgements about injury severity, reflected in their coding injuries as life- or limb-threatening, was almost as good (more than 90% sensitive and specific) as either score and was better in identifying patients sent from the ED to the OR.
InjuryRevised trauma score: a triage tool in the accident and emergency department
69 Citations1991D.A. Gilpin, Peter G. Nelson
The use of the RTS is recommended as an aid to junior doctors in the recognition of seriously injured patients in the accident and emergency department and the score should be recalculated at frequent intervals while the patient remains in the department.
The Journal of Trauma: Injury, Infection, and Critical CareTRAUMA TEAM ACTIVATION FOR “MECHANISM OF INJURY” BLUNT TRAUMA PATIENTS
60 Citations1993Clayton H. Shatney, Koji Sensaki
Initial trauma team evaluation of hemodynamically stable blunt trauma victims whose only reason for trauma center transport is mechanism of injury is needlessly labor intensive and is not cost effective.
The Journal of Trauma: Injury, Infection, and Critical CareTRAUMA CENTER CLOSURES
53 Citations1991J T Dailey, Harry Teter +2 more
It is demonstrated that uncompensated care, inadequate reimbursement, high operating costs, and lack of physician support all adversely affect trauma care in both urban and suburban settings.
The Journal of Trauma: Injury, Infection, and Critical CareA Prospective Evaluation of Field Categorization of Trauma Patients
52 Citations1988David J. Kreis, Ellen Fine +4 more
Evaluating the efficacy of comprehensive field triage in 8,891 trauma patients transported to trauma centers in Dade County, Florida, over a 1-year period ending in September 1986 found a Trauma Score less than or equal to 12 was the most accurate predictor of severe injury.
The Journal of Trauma: Injury, Infection, and Critical CareIMPACT OF MINIMAL INJURIES ON A LEVEL I TRAUMA CENTER
49 Citations1992William S. Hoff, Glen H. Tinkoff +2 more
Continuous re-education of prehospital personnel, increased responsibility of all hospitals in the trauma center catchment area, and protocols for "downstaging" trauma resuscitation in minimally injured patients are proposed.
Emergency Medicine Clinics of North AmericaScoring Systems and Triage from the Field
42 Citations1993Alex M. Maslanka
Until further refinements are made, a prehospital trauma triage system should minimize undertriage and its unnecessary morbidity and mortality.
Annals of Emergency MedicineInjury severity determination: Requirements, approaches, and applications
25 Citations1986Richard H Cales
Injury severity determination serves multiple purposes in trauma care systems by aiding prehospital triage, assisting clinical management, and facilitating outcome evaluation.
The Journal of Trauma: Injury, Infection, and Critical CareThe Integrated Trauma Program
9 Citations1991A. P. Dempster, David E. Wesson +1 more