Monday, February 2, 2009

Field Triage Guidelines for Trauma Patients

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

Getting the trauma patient to the right place at the right time has been shown to save lives.  Arkansas is working to get a trauma system going.  Gov Mike Beebe has proposed a 56 cents sales tax on cigarettes to pay for it.  There are others who feel that the money should come from the ones who cause the trauma.  In their view that includes the folks who speed or drink and drive.  Their proposal is to increase the fines on speeding and DUIs. 
I personally think that burn traumas often come from those who smoke.  How many homes burn due to smoking in bed each year?   Also, there is an increase in motor vehicle accidents due to “trying to light a cigarette” while driving. 
So I would agree with either or a combination of the proposed ways to fund the trauma system.  I just want them to get it in place and working.   The risk of death of a severely injured person is 25 percent lower if the patient receives care at a Level 1 trauma center, which has additional resources  and specifically designed for care of severe trauma.
Last week, the Center for Disease Control and Prevention (CDC) published the MMWR Reports and Recommendations for field triage.  These guidelines are aimed at ensuring that trauma patients with more severe injuries are taken to trauma centers designed to handle such injuries.  These guidelines were developed by CDC and key experts in trauma care.
The recommendations are designed to standardize decision-making at the scene of injury.  They also offer guidance on new technologies such as vehicle crash notification systems, which alert emergency services that a crash has occurred and automatically summon assistance. 

Key revisions include:
  • Recommendations for the right place and right time to best use crucial emergency care resources
  • Vehicle crash damage criteria which can help determine which patients may require care at a trauma center
The Decision Scheme was developed in collaboration with the American College of Surgeons-Committee on Trauma with support from the National Highway Traffic Safety Administration (NHTSA). It was reviewed by the 36-member National Expert Panel on Field Triage, which included representatives from EMS, emergency medicine, trauma surgery, the automotive industry, public health, and several federal agencies.
The revised guidelines are in line with the 2006 Institute of Medicine report on the state of emergency care. The report envisioned a highly coordinated emergency services system that assures that each patient receives the most appropriate care, at the optimal location, with the minimum delay.
With additional funding from NHTSA, CDC is developing a companion educational initiative for local EMS medical directors, state EMS directors, public health officials, and EMS providers.   This toolkit also will be available at no charge from CDC at

For a complete copy of the MMWR report, please visit here.

Center for Disease Control and Prevention

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