A Multisite Assessment of the American College of Surgeons Committee on Trauma Field Triage Decision Scheme for Identifying Seriously Injured Children and Adults

Newgard, Craig D.; Zive, Dana; Holmes, James F.; Bulger, Eileen M.; Staudenmayer, Kristan; Liao, Michael M.; Rea, Thomas D.; Hsia, Renee Y.; Wang, N. Ewen; Fleischman, Ross J.; Jui, Jonathan; Mann, N. Clay; Haukoos, Jason S.; Sporer, Karl A.; Gubler, K. Dean; Hedges, Jerris R.

doi:10.1016/j.jamcollsurg.2011.09.012

Cited by 162 publications

(106 citation statements)

References 59 publications

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“…Motorcycle crash criteria were simplified by deleting the separation of the rider and keeping the speed at more than 20 mph. Data from Newgard et al 26 suggest that the 2006 criteria identify only a small portion of major trauma victims within Steps 1 and 2, while Steps 3 and 4 remain necessary to capture the full spectrum of seriously injured patients.…”

Section: Discussionmentioning

confidence: 99%

Not all mechanisms are created equal

Stuke

Duchesne²,

Greiffenstein³

et al. 2013

Journal of Trauma and Acute Care Surgery

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Section: Discussionmentioning

confidence: 99%

Not all mechanisms are created equal

Stuke

Duchesne²,

Greiffenstein³

et al. 2013

Journal of Trauma and Acute Care Surgery

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“…Major Trauma Triage criteria and decision support tools have been used in the USA since the 1990s (Henry et al, 1996;Newgard et al, 2011;Purtill et al, 2008) to assist Emergency Medical Services (EMS) decision-making. Similar tools have been developed in the UK by expert panels; many have not been formally evaluated to ascertain their validity and reliability.…”

Section: Introductionmentioning

confidence: 99%

Technology for trauma: testing the validity of a smartphone app for pre-hospital clinicians

Freshwater

Crouch

2015

International Emergency Nursing

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Introduction:With the introduction of regional trauma networks in England, ambulance clinicians have been required to make triage decisions relating to severity of injury, and appropriate destination for the patient, which may require 'bypassing' the nearest Emergency Department. A 'Trauma Unit Bypass Tool' is utilised in this process. The Major Trauma Triage tool smartphone application (App) is a digital representation of a tool, available for clinicians to use on their smartphone. Prior to disseminating the application, validity and performance against the existing paper-based tool was explored. Methods: A case-based study using clinical scenarios was conducted. Scenarios, with appropriate triage decisions, were agreed by an expert panel. Ambulance clinicians were assigned to either the paperbased tool or smartphone app group and asked to make a triage decision using the available information. The positive predictive value (PPV) of each tool was calculated. Results: The PPV of the paper tool was 0.76 and 0.86 for the smartphone app. User comments were mainly positive for both tools with no negative comments relating to the smartphone app. Conclusion:The smartphone app version of the Trauma Unit Bypass Tool performs at least as well as the paper version and can be utilised safely by pre-hospital clinicians in supporting triage decisions relating to potential major trauma.

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“…The effect of age, and the alarming increase in mistriage rate at age 70, as represented in Figure 1, represents an area of possible intervention and future study: based on these findings we submit that in persons of advanced age "found down," a multidisciplinary approach is warranted. Prior trauma literature has indicated that triage protocols, even for patients with known mechanism of injury, have decreasing effectiveness in the elderly (12,13), and that undertriage is correlated to worse outcomes in older patients (14). Given the high rate of mistriage seen in age groups over 70, activating both medical and trauma practitioners to provide the initial assessment of these patients could lead to decreased rates of missed injury and medical diagnoses, and thereby prevent potentially harmful delays in diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%