Effectiveness of implementing a trauma triage system on outcome: a prospective evaluation.
A 9-month prospective study was conducted in Salt Lake County to evaluate the efficacy of a field trauma triage system using the CRAMS score. Before the triage system was implemented trauma victims were taken to the nearest appropriate hospital. Post-implementation, trauma victims with field CRAMS scores of 1 through 6 were triaged to the Level I Trauma Center. Of the 113 study patients, 53 were in the pre-implementation phase and 60 in the post-implementation phase. The study patients with CRAMS scores of 4 or less had lower mortality when cared for at the Level I Trauma Center (p = 0.013). We conclude that trauma patients who are severely injured (CRAMS less than or equal to 4) have a significantly higher rate of survival if taken to the Level I Trauma Center. The use of the CRAMS triage system appears to be an effective approach toward improving trauma care in Salt Lake County.
Kilberg
L
L
Department of Medicine, LDS Hospital, Salt Lake City, UT 84143.
Clemmer
T P
TP
Clawson
J
J
Woolley
F R
FR
Thomas
F
F
Orme
J F
JF
D000328:Adult; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D009460:Neurologic Examination; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D014218:Triage / Q000592:standards*; D014589:Utah; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy