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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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References
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Upper extremity amputations after motor vehicle rollovers.

TL;DR: Blunt mangled upper extremities requiring completion amputations are most often caused by MVC rollovers, and seems to be increasing in frequency with summer days.
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Early management of the mangled upper extremity.

TL;DR: The goal of early treatment is to create a clean wound ready for reconstruction as soon as possible, and inadequate debridement will only delay reconstruction to the detriment of the patient.
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The predictive value and appropriate ranges of prehospital physiological parameters for high-risk injured children

TL;DR: Prehospital GCS and respiratory compromise were the most important physiological measures in identifying high-risk injured children, and age-specific criteria should be considered for RR, heart rate, and SBP.
Journal ArticleDOI

The availability and use of out-of-hospital physiologic information to identify high-risk injured children in a multisite, population-based cohort

TL;DR: The incidence of high-risk injured children meeting adult physiologic criteria is relatively low and the findings from this sample do not support using age-specific values to better identify such children, but the amount and pattern of missing data may compromise the value and practical use of field physiologic information in pediatric triage.
Journal ArticleDOI

Is field hypotension a reliable indicator of significant injury in trauma patients who are normotensive on arrival to the emergency department

TL;DR: Field hypotension was a significant marker for potential serious internal injury requiring prompt diagnostic workup in patients treated at a level 1 trauma center over 1 year.
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