History of Trauma Field Triage Development andthe American College of Surgeons Criteria

Abstract

The use of trauma field triage criteria is designed to match a patient's injury type andseverity to prioritized transport andan institution with the resources to provide timely, definitive care. Triage schemes used in austere environments created by war or mass casualty events are less applicable to day-to-day civilian trauma. Civilian triage criteria, developed andrefined over the past 25 years, rely on physiologic, anatomic, andmechanistic indicators of severe injury in an attempt to optimize overtriage andundertriage. As organized trauma systems continue to mature, the need for more accurate direction of high- versus low-acuity patients to regional centers, stratified by their capabilities, becomes more apparent andis essential in avoiding a completely ‘exclusive’ trauma system. New technology utilizing vehicular telemetry andWeb-based information systems may simplify the seemingly simple but often formidable task of creating destination decision rules for victims of major injury.