APPLICATION OF FIELD TRIAGE GUIDELINES BY PREHOSPITAL PERSONNEL - IS MECHANISM OF INJURY A VALID GUIDELINE FOR PATIENT TRIAGE

We prospectively investigated the appropriateness of Mechanism of Inju ry as an exclusive indicator for trauma center triage. For all patient s transported to our level 1 trauma center, EMS personnel identified a pplicable American College of Surgeons' Committee on Trauma field tria ge guidelines. A total of 112 questionnaires were completed. Mechanism of injury was the only reason for trauma center transport in 29. Neit her intubation nor emergent surgery was required in any of these patie nts, and all survived. Only two had an ISS >15. The remaining 83 patie nts had an 11% mortality rate. Fourteen (16.9%) had ISS scores >15. De fining an ISS of 16 or greater as severe injury, mechanism of injury a lone had a positive predictive value of only 6.9%. Mechanism of injury may not, by itself, justify bypass of local hospitals in favor of tra uma centers.