Guidelines for Field Triage of Injured Patients: In conjunction with the Morbidity and Mortality Weekly Report published by the Center for Disease Control and Prevention.
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The methodology, findings and updated guidelines from the Morbidity & Mortality Weekly Report (MMWR) from the 2011 Panel are presented along with commentary on the burden of injury in the U.S., and the role emergency physicians have in impacting morbidity and mortality at the population level.Abstract:
The Centers for Disease Control and Prevention (CDC) has published significant data and trends related to the national public health burden associated with trauma and injury. In the United States (U.S.), injury is the leading cause of death for persons aged 1–44 years. In 2008, approximately 30 million injuries resulted in an emergency department (ED) evaluation; 5.4 million (18%) of these patients were transported by Emergency Medical Services (EMS).1 EMS providers determine the severity of injury and begin initial management at the scene. The decisions to transport injured patients to the appropriate hospital are made through a process known as “field triage.” Since 1986, the American College of Surgeons Committee on Trauma (ACS-COT) has provided guidance for the field triage process though its “Field Triage Decision Scheme.” In 2005, the CDC, with financial support from the National Highway Traffic Safety Administration (NHTSA), collaborated with ASC-COT to convene the initial meeting of the National Expert Panel on Field Triage (the Panel) to revise the decision scheme. This revised version was published in 2006 by ASC-COT, and in 2009 the CDC published a detailed description of the scientific rational for revising the field triage criteria entitled, “Guidelines for Field Triage of Injured Patients.”2–3 In 2011, the CDC reconvened the Panel to review the 2006 Guidelines and recommend any needed changes. We present the methodology, findings and updated guidelines from the Morbidity & Mortality Weekly Report (MMWR) from the 2011 Panel along with commentary on the burden of injury in the U.S., and the role emergency physicians have in impacting morbidity and mortality at the population level.read more
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References
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A National Evaluation of the Effect of Trauma-Center Care on Mortality
Ellen J. MacKenzie,Frederick P. Rivara,Gregory J. Jurkovich,Avery B. Nathens,Katherine Frey,Brian L. Egleston,David S. Salkever,Daniel O. Scharfstein +7 more
TL;DR: It is shown that the risk of death is significantly lower when care is provided in a trauma center than in a non-trauma center and argue for continued efforts at regionalization.
Journal Article
Guidelines for field triage of injured patients recommendations of the national expert panel on field triage.
Scott M. Sasser,Scott M. Sasser,Richard C. Hunt,Ernest E. Sullivent,Marlena M. Wald,Jane Mitchko,Gregory J. Jurkovich,Mark C. Henry,Jeffrey P. Salomone,Stewart C. Wang,Robert L. Galli,Arthur Cooper,Lawrence H. Brown,Richard W. Sattin +13 more
TL;DR: In this paper, the authors present the dissemination and impact of the 2006 Guidelines for field triage of injured patients; outlines the methodology used by the Panel for its 2011 review; explains the revisions and modifications to the physiologic, anatomic, mechanism-of-injury, and special considerations criteria; and provides the rationale used by Panel for these changes.
Journal ArticleDOI
Access to trauma centers in the United States.
Charles C. Branas,Ellen J. MacKenzie,Justin C. Williams,C. William Schwab,Harry Teter,Marie Flanigan,Alan Blatt,Charles ReVelle +7 more
TL;DR: Selecting trauma centers based on geographic need, appropriately locating medical helicopter bases, and establishing formal agreements for sharing trauma care resources across states should be considered to improve access to trauma care in the United States.
Journal ArticleDOI
The effect of trauma center designation and trauma volume on outcome in specific severe injuries
TL;DR: Level I trauma centers have better outcomes than lower-level centers in patients with specific injuries associated with high mortality and poor functional outcomes, and the volume of major trauma admissions does not influence outcome in either level I or II centers.
Journal ArticleDOI
Outcome of Hospitalized Injured Patients After Institution of a Trauma System in an Urban Area
Richard J. Mullins,Judith Veum-Stone,Mark Helfand,Melanie J. Zimmer-Gembeck,Jerris R. Hedges,Patricia Southard,Donald D. Trunkey +6 more
TL;DR: Establishment of a trauma system shifted the more seriously injured patients to level I trauma centers, where there was a significant reduction in the adjusted death rate.