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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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Journal ArticleDOI

Mortality from isolated civilian penetrating extremity injury.

TL;DR: Although rare, death from isolated extremity injuries does occur in the civilian population and the cause of death in this series appears to have been exsanguination, although definitive etiology cannot be discerned.
Journal ArticleDOI

Normal presenting vital signs are unreliable in geriatric blunt trauma victims.

TL;DR: Vital signs on presentation are less predictive of mortality in geriatric blunt trauma patients, and new trauma triage set points of HR >90 or SBP <110 mm Hg should be considered in the geriatric limp trauma patients.
Book

Rosen's emergency medicine :

TL;DR: Rosen's emergency medicine : , Rosen's emergency Medicine : , کتابخانه دیجیتالی دانشگاه علوم پزشدکی و شهید بهشتی.
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Lactate is a better predictor than systolic blood pressure for determining blood requirement and mortality: could prehospital measures improve trauma triage?

TL;DR: ED-BL is a better predictor than SBP in identifying patients requiring significant transfusion and mortality in this cohort with indeterminant SBP, suggesting that point-of-care BL measurements could improve trauma triage and better identify patients for enrollment in interventional trials.
Journal ArticleDOI

The impact of advanced age on trauma triage decisions and outcomes: A statewide analysis

TL;DR: Elderly trauma victims are less likely to undergo rapid trauma evaluation and have significantly worse outcomes compared with younger patients, and standard physiologic triage variables may not identify severe injury in older patients.
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