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Studies evaluating current field triage: 1966-2005.

E Brooke Lerner1

  • 1Department of Emergency Medicine, University of Rochester, Rochester, NY 14642, USA. brooke586@yahoo.com

Prehospital Emergency Care
|June 28, 2006
PubMed
Summary
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The American College of Surgeons field triage guidelines lack sufficient evidence for overall effectiveness. However, the physiologic and anatomic criteria show promise for improving trauma patient assessment and transport decisions.

Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Public Health Policy

Background:

  • The American College of Surgeons (ACS) field triage guidelines are crucial for directing trauma patients to appropriate care facilities.
  • Accurate field triage ensures timely access to specialized trauma centers for critically injured individuals.

Purpose of the Study:

  • To systematically review the literature and evaluate the sensitivity and specificity of the ACS field triage criteria.
  • To assess the effectiveness of individual components within the ACS triage guidelines.

Main Methods:

  • A comprehensive literature search of MEDLINE (1966-2005) using keywords related to emergency medical services, triage, and wounds and injury.
  • Inclusion of articles from reference sections and other organizational searches to ensure thoroughness.

Related Experiment Videos

  • Analysis of five studies evaluating the full ACS criteria and specific triage steps.

    • Main Results:

    • Limited evidence supports the overall ACS field triage criteria, with only two studies calculating specificity (8%) and sensitivity (95%-97%).
    • The physiologic step demonstrated a sensitivity of 56% and specificity of 86% in one study.
    • The anatomic step showed a sensitivity of 45% in one analyzed study.

    Conclusions:

    • There is insufficient evidence to validate the comprehensive ACS field triage guidelines.
    • The physiologic and anatomic components of the ACS criteria exhibit the strongest evidence base among the evaluated steps.
    • Further research is needed to refine and validate field triage protocols for optimal trauma patient management.