Triage in trauma-care system: a forensic view

Trauma is a significant cause of death and suffering in society and there is strong evidence that mortality and morbidity may be reduced by provision of effective medical care through a trauma care system. It is reasonable to believe that severely injured patients should be transported as quickly as possible to a center where definitive medical care is possible. Conversely, it is also an argument that the resources of a trauma center must not be overwhelmed by assessment and treatment of minor trauma for patients who could be reasonably expected to do well with care in a clinic or a primary care hospital. Triage was developed to sort out those most likely to survive and to need medical care. Many triage tools have been developed and evaluated. However, the goal in setting triage criteria to provide a protocol for properly categorising injured patients, transporting them to appropriate hospitals, and ensuring an appropriate response to all trauma patients is yet to be achieved. Whatever the reasons and rate of failure due to different reasons, it is not unusual to read the reports wherein the quality of care becomes suspect in an increasingly litigious society. This paper examines the evolution of triage systems in trauma care from a forensic viewpoint.