Optimal Trauma Activation Criteria for "Found Down" Patients.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Clinical Triage

Background:

• Patients found down (FD) with unknown injury mechanisms pose a triage dilemma.
• Previous "suspicion of trauma" criteria led to high mis-triage rates.
• Triage was modified to focus on "signs of trauma" to improve accuracy.

Purpose of the Study:

• Compare injured and uninjured FD patients.
• Identify patient characteristics and outcomes.
• Evaluate the accuracy of "signs of trauma" as a triage criterion.

Main Methods:

• Retrospective review of adult FD patients (1/2019-4/2021).
• Categorized patients as injured or uninjured based on Injury Severity Score (ISS).
• Calculated sensitivity and specificity for "signs" and "suspicion" of trauma criteria.

Main Results:

• 273 (65.8%) of 415 FD patients were injured; 142 (34.2%) were uninjured.
• "Signs of trauma" demonstrated high sensitivity (96.0%) and moderate specificity (82.4%) for injury.
• "Suspicion of trauma" showed low sensitivity (2.2%) and specificity (37.3%).

Conclusions:

• Injured and uninjured FD patients share similar characteristics (GCS, vitals), complicating identification.
• "Signs of trauma" are a valuable and accurate indicator for identifying injury in FD patients.
• This supports the modified triage strategy focusing on physical signs.