Field triage, and the fragile supply of "optimal resources" for the care of the injured patient

Abstract

Conventional field triage schemes, including those discussed in this series of reports, assume a high degree of consistency in the availability of resources at designated receiving hospitals. In an organized trauma system, designated trauma receiving facilities of all levels are typically required to maintain a high level of consistency in terms of available facility and human resources for the care of the injured patient. These resources, both facility and provider, are becoming increasingly vulnerable to gaps in availability, however, for a variety of reasons. When gaps in resource availability do occur, their often unpredictable nature nullifies the effectiveness of any established triage protocol, may result in trauma center closures or downgrades, and undermines the entire system of care. It may be necessary in some regions to develop more flexible triage processes, creating a time-sensitive responsiveness to fluctuations in resource availability in a way that dynamically minimizes overtriage and undertriage.