A prospective comparison of paramedic judgment and the trauma triage rule in the prehospital setting.
OBJECTIVE
To study paramedic judgment and the Trauma Triage Rule in prehospital trauma triage.


METHODS
Prospective.


METHODS
A county emergency medical services system.


METHODS
Six hundred fifty-three trauma patients.


RESULTS
Over a 3-month period, 653 trauma patients were evaluated in the prehospital setting. Paramedic judgment and the Trauma Triage Rule (TTR), as described by Baxt, were evaluated for accuracy in identifying patients requiring trauma center care. The TTR achieved a sensitivity of 88% and a specificity of 86%. Paramedic judgment had a sensitivity of 91% and a specificity of 60%. Combining the TTR and paramedic judgment achieved a sensitivity of 100% and a specificity of 75%.


CONCLUSIONS
The TTR and paramedic judgment are effective in identifying patients who require trauma center care in the prehospital setting. The TTR and paramedic judgment combined have the greatest predictive value in identifying seriously injured patients.
Department of Emergency Medicine, Highland General Hospital, University of California at San Francisco, Oakland.
G R
GR
Fries
G
G
McCalla
M A
MA
Levitt
R
R
Cordova
D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel / Q000523:psychology*; D002140:California; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology