Triage

The process of triaging injured patients in the out-of-hospital setting is a critically important aspect of concentrating persons with serious injuries in major trauma centers, where previous research has demonstrated improved outcomes. Because the majority of seriously injured patients access acute care through 9-1-1 emergency medical services (EMS), an accurate and effective field process for getting the “right” patients to the “right” place is a vital aspect of regionalized trauma care. The current template for field trauma triage was developed more than two decades ago, with minor periodic revisions. These guidelines have been widely promoted and integrated into most US trauma systems. However, despite the importance of field triage and a large existing body of research, many triage issues remain poorly understood. This chapter provides a detailed evaluation of the existing trauma triage literature, the triage algorithm and its presumed accuracy, critical concepts integral to field triage, key limitations and gaps in existing triage research, unique populations, out-of-hospital cognitive reasoning in triage, and future directions.