THE TRAUMA TRIAGE RULE - A NEW, RESOURCE-BASED APPROACH TO THE PREHOSPITAL IDENTIFICATION OF MAJOR TRAUMA VICTIMS

被引:107
作者
BAXT, WG
JONES, G
FORTLAGE, D
机构
[1] Department of Emergency Medicine, University of California, San Diego, Medical Center
[2] Department of Surgery, University of California, San Diego, Medical Center
关键词
trauma; triage;
D O I
10.1016/S0196-0644(05)82608-3
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objective: To develop a new trauma decision rule. Design: Retrospective clinical review. Setting: Level 1 trauma center. Type of participants: 1,004 injured adults. Measurements and main results: A new trauma decision rule was derived from 1,004 injured adult patients using a new operational definition of major trauma. The rule, termed the Trauma Triage Rule, defines a major trauma victim as any injured adult patient whose systolic blood pressure is less than 85 mm Hg; whose motor component of the Glasgow Coma Score is less than 5; or who has sustained penetrating trauma of the head, neck, or trunk. Using the operational definition of major trauma, the rule had a sensitivity of 92% and a specificity of 92% when tested on the 1,004-patient cohort. Conclusion: The Trauma Triage Rule may significantly reduce overtriage while only minimally increasing undertriage. This approach must be validated prospectively before it can be used in the prehospital setting. © 1990 American College of Emergency Physicians.
引用
收藏
页码:1401 / 1406
页数:6
相关论文
共 25 条
  • [1] West, Williams, Trunkey, Et al., Trauma systems: Current status — Future challenges, JAMA, 259, pp. 3597-3600, (1988)
  • [2] Aprahamian, Wolferth, Darin, Et al., Status of trauma center designation, The Journal of Trauma: Injury, Infection, and Critical Care, 29, pp. 566-570, (1988)
  • [3] Clemmer, Orme, Thomas, Et al., Prospective analysis of the CRAMS score for major trauma, J Trauma, 25, pp. 188-191, (1985)
  • [4] Clemmer, Orme, Thomas, Et al., Outcome of critically injured patients treated at level 1 trauma centers vs. full-service community hospitals, Crit Care Med, 13, pp. 861-863, (1985)
  • [5] Clemmer, Thomas, Thomas, Et al., Comparison of the Trauma Score and CRAMS score for trauma triage, Critical Care Medicine, 14, (1986)
  • [6] Ornato, Mlinek, Craren, Et al., Ineffectiveness of the Trauma Score and the CRAMS Scale for accurately triaging patients to trauma centers, Ann Emerg Med, 14, pp. 1061-1064, (1985)
  • [7] Morris, Auerbach, Marshall, Et al., The Trauma Score as a triage tool in the prehospital setting, JAMA, 256, pp. 1319-1325, (1986)
  • [8] Knudson, Frecerri, DeLateur, Improving the field triage of major trauma victims, J Trauma, 28, pp. 602-606, (1988)
  • [9] Baxt, Berry, Epperson, Et al., The failure of prehospital trauma prediction rules to classify trauma patients accurately, Ann Emerg Med, 18, pp. 1-8, (1989)
  • [10] Eichelberger, Gotschall, Sacco, Et al., A comparison of the Trauma Score, the Revised Trauma Score, and the Pediatric Trauma Score, Ann Emerg Med, 18, pp. 1053-1058, (1989)