title: The sensitivity of pre-hospital and in-hospital tools for the identification of major trauma patients presenting to a major trauma centre.
abstract: The identification of major trauma patients before arrival in hospital allows the activation of an appropriate trauma response. The Wessex triage tool (WTT) uses a combination of anatomical injury assessment and physiological criteria to identify patients with major trauma suitable for triage direct to a major trauma centre (MTC), and has been adopted by the South-West Peninsula Trauma Network (PTN). A retrospective database review, using the Trauma Audit Research Network (TARN) database, was undertaken to identify a population of patients presenting to Derriford Hospital with an injury severity score (ISS) >15. The WTT was then applied to this population to identify the sensitivity of the tool. The sensitivity of the WTT at identifying patients with an ISS> 15 was 53%. One of the reasons for this finding was that elderly patients who are defined as having major trauma due to the nature of their injuries, but who did not have a mechanism to suggest they had sustained major trauma (such as a fall from standing height), were not identified by these triage tools. The implications of this are discussed.
authors.affiliation: Emergency Department, Derriford Hospital, Plymouth, UK.
authors.forename: D
authors.initials: D
authors.lastname: Potter
authors.forename: A
authors.initials: A
authors.lastname: Kehoe
authors.forename: J E
authors.initials: JE
authors.lastname: Smith
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000209:etiology