Trauma Triage

Question 1

Physiological Criteria

Answer 1

-Systolic blood pressure <90
-Respiratory rate <10 or >29
-Glasgow coma scale <14

Question 2

Anatomical Criteria

Answer 2

-2 or more proximal long bone fractures
-Flail chest
-Pelvic fracture
-Limb paralysis
-Penetrating trunk, neck, or head trauma
-Crushed or mangled extremity
-Amputation proximal to wrist and ankle
-Paralysis
-Open or depressed skull fracture

Question 3

MOI Criteria

Answer 3

-Falls
*adults: >20 ft
*children: >10 ft or 2 or 3 times the height of the child
-High-risk auto crash
*intrusion, 12 inches occupant side; 18 inches any site
*ejection (partial or complete) from automobile
*death in same passenger compartment
*vehicle telemetry data consistent with a high risk of injury
-Auto vs pedestrian/bicyclist thrown. run over, or with significant (>20 mph) impact
-Motorcycle crash >20 mph

Question 4

Special Considerations

Answer 4

-Older adults
*risk of injury/death increases after age 55
*SBP <110 might represent shock after age 65
*low impact mechanism might result in severe injury
-Children
*should be triaged preferentially to pediatric-capable trauma centers
-Anticoagulants and bleeding disorders
*patients with head injury are at high risk for rapid deterioration
-Burns
*without other trauma mechanism: triage to burn facility
*with trauma mechanism: triage to trauma center
-Pregnancy >20 weeks
-EMS provider judgment