Secondary triage with a tiered response is safe, accurate, and useful in optimizing team and resource utilization. Note: If not done appropriately, workup time and ED length of stay may increase.
A combination of physiologic and anatomic parameters with mechanism provides better triage than any single factor.
Mechanism alone may not be useful and should not be used as stand alone criteria for highest level trauma team response.
A combination of physiologic and anatomic parameters along with mechanism of injury (MOI), comorbidities, and demographics provides better triage than any smaller combination or any alone.
If one considers single criteria, then physiologic parameters give the most accurate triage followed by anatomic parameters. Certain mechanisms are better indicators than others. Comorbidities and field personnel judgment have the lowest yields.
Level 3
Field personnel judgment should still be a factor in prehospital trauma triage but is more effective when there is physician medical control.
Extrication time over 20 minutes and death of occupant in same vehicle may be considered as stand alone triage criteria.
All other mechanisms may not be useful in and of themselves as triage criteria.
The Revised Trauma Score (rTS), Prehospital Index (PHI), Trauma Score (TS), CRAMS (Circulation, Respiration, Abdomen, Motor GCS, and Speech GCS), Baxt Trauma Triage Rule (TTR), and Triage Index are not to be used as standalone criteria to triage patients.
There should be increased weight given to advanced age (≥65) during triage.
