The trauma score as a triage tool in the prehospital setting

J. A. Morris, P. S. Auerbach, G. A. Marshall, R. F. Bluth, L. G. Johnson, Donald Trunkey

Research output: Contribution to journalArticlepeer-review

Abstract

Implementation of a regional trauma care system requires a field triage tool that identifies the severely injured patient and transports him to a trauma center, while preserving the flow of minimally injured patients to community hospitals. We prospectively tested the Trauma Score (TS) as a field triage tool and evaluated its accuracy against that of the Injury Severity Score (ISS), calculated after the patients' injuries were fully defined. During an 18-month period, 1106 patients admitted to the trauma center at San Francisco General Hospital had a TS determined in the field (TS1) and on arrival at the emergency department. A TS1 of 14 or less defined a subgroup of 222 patients in whom 93% of the deaths occurred. Using an ISS of 20 or more as an indicator of life-threatening injury, we determined the predictive value of TS1. There were 66 false-negatives (ISS, ≥20; TS1, 15 or 16) and 107 false-positives (ISS, 1, ≤14). Using a prehospital TS of 14 or less as an indicator of serious injury, only 20% of a major urban trauma population would qualify for diversion to a trauma center.

Original languageEnglish (US)
Pages (from-to)1319-1325
Number of pages7
JournalJournal of the American Medical Association
Volume256
Issue number10
DOIs
StatePublished - 1986
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine

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