Field Triage Decision Scheme: The National Trauma Triage Protocol Guidelines for the transfer of critically ill patients, Critical Care Medicine, American College of Critical Care Medicine (ACCM). Lippincott Williams and Wilkins, 1993, 21, 931–937.
FIELD TRIAGE DECISlON SCHEME: THE NATIONAL TRAUMA TRIAGE PROTOCOL
l Measure vital signs and level or consciousness
1 Glasgow Coma Scale <14 or Systolic blood pressure <90 or Respiratory rate <10 or >29 (<20 in inrant < one year) i yes i | No I
Take to a trauma centert Steps 1 and 2 attempt to identity the most seriously injured patients, These patients should be transported Assess anatomy of injury preferentially to the highest level of care within the trauma system.
- All penetrating injuries to head. neck, torso, and extremitites proximal to elbow and knee ' Flail chest - Two or more, proximal lenghone teatures 2 ' Crushed, degloved, or mangled extremity - Amputation proximal to wrist and ankle ' Pelvic fractures ~ Open or depressed skull fracture
- Paralysis i v25 [ | NO | Take to a trauma center. Steps 1 and 2 attempt to identify the most Assess mechanism of injury seriously injured patients. These patients should be transported and evidence or preierentieiiy to the highest level of care within the trauma system. high-energy impact Falls
- Adults; >20 ft. (one story is equal to 10 ft)
- Ch ren: >10 it. or 2—3 times the height ofthe child High-Risk Auto Crash 3 . Intrusion: >12 in. occupant site; >18 in. any site
- Ejection ipanial or complete) trom automobile
- Death in same passenger compartment
. Vehicle telemetry data consistent with high risk of injury Auto v. Pcdestrian/Bieyclist Thrown, Run Over, or with Sign Motorcycle crash >20 MPH
want (>20 MPH) Impact
ivzsi [Moi
Transport to closest appropriate trauma center, which depending on the trauma system, need not be the highest level trauma centert
Assess special patient or system considerations
Age - Older Adults: Risk or injury death increases after age 55 ~ Children: Should be triaged preferentially to pediatric-capable trauma centers Anticoagulction and aloeding Disorders
Burns 4 ' Without other trauma mechanism: Triage to burn facility - With trauma mechanism: Triage to trauma center nrne Sensitive Extremity injury End-Stage Renal Disease Requiring Dinlysis Pregnancy )10 Weeks EMS Provider Judgment
ivssi |No|
Contact medical control and consider transport to a trauma center
.. . Trans onaccordin to rotocol oraspecihcrescurce hospital. i i p 9 p
When in doubt, transport to a trauma center: For more information, visit: www,cdc.gov/Fie|dTriage
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