Field Triage Decision Scheme

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