Pediatric trauma: getting triage right

Abstract

To the Editor.— I enjoyed reading the article entitled Evaluation of the Pediatric Trauma Score, 1 but I am having some problems with the authors' conclusions in relation to overtriaging and undertriaging of the two severity scores. While I agree that overtriaging (Pediatric Trauma Score more responsible than the Revised Trauma Score) is a serious problem, especially in these days of cost containment, I also think that undertriaging (Revised Trauma Score more responsible than the Pediatric Trauma Score) is an even more serious problem, given the consequences of inadequate medical care. There is more to the cost of trauma than just direct medical costs. I was also puzzled by the extolling of the virtues of a triaging system with fewer parameters after a paragraph that seems to indicate that the Revised Trauma Score's undertriage rate could be improved by inclusion of specific injury criteria and evidence of high impact, thereby