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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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TLDR
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.

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Journal ArticleDOI

Management and outcomes of trauma during pregnancy.

TL;DR: Pregnancy-related morbidity occurs in approximately 25% of cases and may include placental abruption, uterine rupture, preterm delivery, and the need for cesarean delivery.
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The association of insurance status on the probability of transfer for pediatric trauma patients

TL;DR: Among pediatric trauma patients, lack of insurance is an independent predictor for transfer to a major trauma center and these findings suggest a triage bias influenced by insurance status.
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Not all mechanisms are created equal: a single-center experience with the national guidelines for field triage of injured patients

TL;DR: With the exception of vehicle intrusion and MCC, the new National Trauma Triage Criteria accurately predicts TCN and extrication time of more than 20 minutes was a positive predictor of TCN in the system.
Journal ArticleDOI

Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome.

TL;DR: There was no difference in the type of TBI, Glasgow Coma Scale (GCS) upon arrival at the trauma center, or overall mortality between referred and directly admitted patients, and interhospital transfer does not affect the outcome of blunt trauma patients.
Journal ArticleDOI

Trauma Systems: Origins, Evolution, and Current Challenges

TL;DR: The growth and development of civilian trauma systems has not been an easy process and the concept of regionalized health care that the trauma system models has been emulated by other specialized and time-sensitive areas of medicine, notably stroke and acute cardiac events.
References
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Journal ArticleDOI

A National Evaluation of the Effect of Trauma-Center Care on Mortality

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.

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.

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

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.
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