title: Trauma victims: field triage guidelines.
abstract: Trauma kills more Americans from age 1 to 34 than all diseases combined. Until recently, trauma care in the United States was delivered in a nonorganized, nonintegrated fashion, with trauma victims being transported to the medical facility closest to the scene of the accident. Many recent studies confirm an unacceptably high incidence--up to 75% in some studies--of preventable deaths in trauma victims treated under the nearest hospital system. This has resulted in the development of specialized trauma centers. The concept of a regional trauma center requires restrictive medical practice in which a limited number of hospitals and physicians provide care for those 5% to 12% of patients who are critically injured. The decision on whether to take a patient to the closest hospital or to the regional trauma center is a form of triage, with far-reaching consequences medically, ethically, and financially. Various triage instruments have been developed to try to identify those patients who would benefit from the resources of a trauma center, and to avoid overcrowding those centers with patients having less serious injuries. These triage tools are based on a combination of mechanism of injury, anatomic criteria, physiologic criteria, and co-morbidity factors.
mesh_terms: D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards*; D005845:Georgia; D006801:Humans; D008875:Middle Aged; D014193:Trauma Centers; D014218:Triage / Q000592:standards*; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy