The new Morbidity and Mortality Weekly Report is an issue on Guidelines for Field Triage of Injured Patients. Required reading. It describes the changing field triage criteria, which is now more evidenced-based and relies less on mechanism of injury than the previous version.
January 23, 2009 / Vol. 58 / No. RR–1
Guidelines for Field Triage of Injured Patients
Recommendations of the National Expert Panel on Field Triage
In the United States, injury is the leading cause of death for persons aged 1-44 years, and the approximately 800,000 emergency medical services (EMS) providers have a substantial impact on care of injured persons and on public health. At an injury scene, EMS providers determine the severity of injury, initiate medical management, and identify the most appropriate facility to which to transport the patient through a process called “field triage”. In 1987, the American College of Surgeons developed the Field Triage Decision Scheme (Decision Scheme), which serves as the basis for triage protocols for state and local EMS systems across the United States. Since its initial publication in 1987, the Decision Scheme has been revised four times. In 2005, with support from the National Highway Traffic Safety Administration, CDC began facilitating revision of the Decision Scheme by hosting a series of meetings of the National Expert Panel on Field Triage, which includes injury-care providers, public health professionals, automotive industry representatives, and officials from federal agencies. The Panel reviewed relevant literature, presented its findings, and reached consensus on necessary revisions. The revised Decision Scheme was published in 2006. This report describes the process and rationale used by the Expert Panel to revise the Decision Scheme.
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