Variation in Prehospital Trauma Triage Protocols.

Area of Science:

• Emergency Medicine
• Trauma Care
• Public Health Policy

Background:

• Trauma patients represent a significant population with high morbidity, underscoring the critical importance of effective prehospital care.
• Current prehospital trauma triage protocols in the United States exhibit considerable variability.

Purpose of the Study:

• To evaluate the current status and consistency of prehospital trauma triage protocols nationwide.
• To identify variations in trauma center categorization, triage criteria, and transport guidelines.

Main Methods:

• Analysis of statewide emergency medical services (EMS) protocols from U.S. states.
• Assessment of trauma centers, triage criteria (physiologic, anatomic, mechanism, patient factors), and transport guidance.

Main Results:

• 29 out of 31 states (94%) have prehospital trauma triage criteria, often with two or four categories.
• Commonly used criteria include systolic blood pressure, respiratory rate, central penetrating trauma, and mechanism of injury (e.g., pedestrian vs. automobile).
• Significant heterogeneity exists in protocol structure, indications, destination determination, and helicopter transport guidelines.

Conclusions:

• There is substantial heterogeneity in the structure and indications for prehospital trauma triage criteria across the U.S.
• Standardization of these protocols is essential to ensure consistent and appropriate care for all trauma patients.