Sage Journals: Discover world-class research

Abstract

The goal of trauma triage is to get the right patient to the right place at the right time. In an attempt to achieve this objective numerous authors have developed a variety of prehospital triage tools. Comparative evaluation to determine which of the currently developed triage tools has the greatest predictive power has been prevented mainly because of the varying definitions of major trauma. The use of small data sets and the absence of model validation techniques have also prevented the true worth of these triage tools from being accurately determined. The aim of this article is to critically appraise the major prehospital triage tools.

Keywords

prehospital triage trauma scoring trauma triage

Get full access to this article

View all access options for this article.

References

Baxt WG , Upenieks V. 1990. The lack of full correlation between the injury severity score and the resource needs of injured patients. Ann Emerg Med 19: 1396-1400.

Baxt WG , Jones G , Fortlage D. 1990. The Trauma Triage Rule: a new resource-based approach to the prehospital identification of major trauma victims. Ann Emerg Med 19: 1401-1406.

Bond RJ , Kortbeek JB , Preshaw RM. 1997. Field trauma triage: combining mechanism of injury with the Prehospital Index for an improved trauma triage tool. J Trauma 43: 283-287.

Champion HR , Sacco WJ , Hannan DS et al . 1981a. Assessment of injury severity: the Triage Index. Crit Care Med 8: 201-208.

Champion HR , Sacco WJ , Carnazzo AJ et al . 1981b. The Trauma Score. Crit Care Med 9: 672-676.

Champion HR , Sacco WJ , Copes WS et al . 1989. A revision of the Trauma Score. J Trauma 29: 623-629.

Clemmer TP , Orme JF , Thomas F et al . 1985. Prospective evaluation of the CRAMS scale for triaging major trauma. J Trauma 25: 188-191.

Clemmer TR , Thomas C , Thomas F et al . 1986. Comparison of the trauma score and CRAMS scores for trauma triage. Crit Care Med 14: 427-427.

Deane SA , Gaudry PL , Roberts et al . 1986. Trauma triage - a comparison of the trauma score and the vital signs score. Aust NZ J Surg 56: 191-197.

10.

Emerman CL , Shade B , Kubincanek J. 1991. A comparison of EMT judgement and prehospital trauma triage instruments. J Trauma 31: 1369-1375.

11.

Emerman CL , Shade B , Kubincanek J. 1992. Comparative performance of the Baxt Trauma Triage Rule. Am J Emerg Med 10: 294-297.

12.

Gilpen DA , Nelson PG. 1991. Revised Trauma Score: a triage tool in the accident and emergency department. Injury 22: 35-37.

13.

Gormican SP. 1982. CRAMS scale: field triage of trauma victims. Ann Emerg Med 11: 132-135.

14.

Gray A , Goyder EC , Goodacre SW et al . 1997. Trauma triage: a comparison of CRAMS and TRTS in a UK population. Injury 28: 97-101.

15.

Hedges JR , Feero S , Moore B et al . 1987. Comparison of pre-hospital trauma triage instruments in a semirural population. J Emerg Med 5: 197-208.

16.

Kane G , Engelhardt R , Celentano J et al . 1985. Empirical development and evaluation of prehospital triage instruments. J Trauma 25: 482-489.

17.

Kirkpatrick JR , Youmans RL. 1971. Trauma Index. An aide in the evaluation of injury victims. J Trauma 11: 711-714.

18.

Knudson P , Frecceri CA , DeLateur SA. 1988. Improving field triage of major trauma victims. J Trauma 28: 602-606.

19.

Koehler JJ , Baser LJ , Malafa S et al . 1986. Prehospital index: a scoring system for field triage of trauma victims. Ann Emerg Med 15: 178-182.

20.

Koehler JJ , Malafa SA , Hillesland J et al . 1987. A multicenter validation of the Prehospital Index. Ann Emerg Med 16: 380-385.

21.

Lett RR , Hanley HA , Smith JS. 1995. The comparison of injury severity instruments performance using likelihood ratio and ROC curve analyses. J Trauma 38: 142-148.

22.

Lowe DK , Oh GR , Neely KW et al . 1983. Evaluation of injury mechanism as a criterion in trauma triage. Am J Surg 152: 6-10.

23.

Meredith W , Rutledge R , Hansen AR et al . 1995. Field triage of trauma patients based upon the ability to follow commands: a study in 29,573 injured patients. J Trauma 38: 129-135.

24.

Morris JA , Auerbach PS , Marshall GA et al . 1986. The Trauma Score as a triage tool in the prehospital setting. J Am Med Assoc 256: 1319-1325.

25.

Ogawa M , Sugimoto T. 1974. Rating severity of the injured by ambulance attendants. J Trauma 14: 934-937.

26.

Ornato J , Mlinek EJ , Nebraska O et al . 1985. Ineffectiveness of the Trauma Score and the CRAMS scale for accurately triaging patients to trauma centres. Ann Emerg Med 14: 1061-1064.

27.

Plant JR , MacLeod DB , Kortbeek J. 1995. Limitations of the Prehospital Index in identifying patients in need of a major trauma centre. Ann Emerg Med 26: 133-137.

28.

Poses PM , Cebul RD , Collins M et al . 1986. The importance of disease prevalence in transporting clinical prediction rules. Ann Intern Med 105: 586-591.

29.

Samplas JS , Tamim H , Nikolis A et al . 1996. Predictive validity and internal consistency of the prehospital Index measured on-site by physicians. Accid Anal Prev 28: 675-684.

30.

Smith JS , Bartholomew MJ. 1990. Trauma index revisited: a better triage tool. Crit Care Med 18: 174-180.

31.

Trunkey DP , Siegel J , Baker SP et al . 1983. Panel: current status of trauma severity indices. J Trauma 23: 185-201.

32.

Wigton RS , Connor JL , Centor RM. 1986. Transportability of a decision rule for the diagnosis of streptococcal pharyngitis. Arch Intern Med 146: 81-83.

33.

Zechnich AD , Hedges JR , Spackman K et al . 1995. Applying the trauma triage rule to blunt trauma patients. Acad Emerg Med 2: 1043-1052.