DO PREHOSPITAL TRAUMA CENTER TRIAGE CRITERIA IDENTIFY MAJOR TRAUMA VICTIMS

Objective: To evaluate anatomic, physiologic, and mechanism-of-injury prehospital triage criteria as well as the subjective criterion of pro vider ''gut feeling.'' Design: Prospective analysis. Setting: A state without a trauma system or official trauma center designation. Patient s: Patients treated by emergency medical services personnel statewide over a 1-year period who were injured and met at least one prehospital triage criterion for treatment at a trauma center. Main Outcome Measu res: Outcome was analyzed for injury severity using the Injury Severit y Score and mortality rates. a major trauma victim (MTV) was defined a s a patient having an Injury Severity Score of 16 or greater. The yiel d of MTV and mortality associated with each criterion was determined. Results: Of 5028 patients entered into the study, 3006 exhibited a sin gular entry criterion. Triage criteria tended to stratify into high-, intermediate-, and low-yield groups for MTV identification. Physiologi c criteria were high yield and anatomic criteria were intermediate yie ld. Provider gut feeling alone was a low-yield criterion but served to enhance the yield of mechanism of injury criteria when the two criter ia were applied in the same patient. Conclusions: A limited set of hig h-yield prehospital criteria are acceptable indicators of MTV. Isolate d low- and intermediate-yield criteria may not be useful for initiatin g trauma center triage or full activation of hospital trauma trams.