Field-Triage, Hospital-Triage and Triage-Assessment: A Literature Review of the Current Phases of Adult Trauma Triage

doi:10.1097/TA.0000000000003125

Review

. 2021 Jun 1;90(6):e138-e145.

doi: 10.1097/TA.0000000000003125.

Field-Triage, Hospital-Triage and Triage-Assessment: A Literature Review of the Current Phases of Adult Trauma Triage

Rachel S Morris¹, Basil S Karam, Patrick B Murphy, Peter Jenkins, David J Milia, Mark R Hemmila, Krista L Haines, Thaddeus J Puzio, Marc A de Moya, Christopher J Tignanelli

Affiliations

Affiliation

¹ From the Department of Surgery (R.M., B.S.K., P.M., D.M., M.d.M.), Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Surgery (P.J.), Indiana University, Indianapolis, Indiana; Department of Surgery (M.H.), University of Michigan, Ann Arbor, Michigan; Department of Surgery (K.H.), Duke University, Durham, North Carolina; Department of Surgery (T.P.), University of Texas Health Science Center, Houston, Texas; Department of Surgery (C.T.), and Institute for Health Informatics (C.T.), University of Minnesota, Minneapolis; and Department of Surgery (C.T.), North Memorial Health Hospital, Robbinsdale, Minnesota.

PMID: 33605709
DOI: 10.1097/TA.0000000000003125

Review

Field-Triage, Hospital-Triage and Triage-Assessment: A Literature Review of the Current Phases of Adult Trauma Triage

Rachel S Morris et al. J Trauma Acute Care Surg. 2021.

. 2021 Jun 1;90(6):e138-e145.

doi: 10.1097/TA.0000000000003125.

Authors

Rachel S Morris¹, Basil S Karam, Patrick B Murphy, Peter Jenkins, David J Milia, Mark R Hemmila, Krista L Haines, Thaddeus J Puzio, Marc A de Moya, Christopher J Tignanelli

Affiliation

¹ From the Department of Surgery (R.M., B.S.K., P.M., D.M., M.d.M.), Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Surgery (P.J.), Indiana University, Indianapolis, Indiana; Department of Surgery (M.H.), University of Michigan, Ann Arbor, Michigan; Department of Surgery (K.H.), Duke University, Durham, North Carolina; Department of Surgery (T.P.), University of Texas Health Science Center, Houston, Texas; Department of Surgery (C.T.), and Institute for Health Informatics (C.T.), University of Minnesota, Minneapolis; and Department of Surgery (C.T.), North Memorial Health Hospital, Robbinsdale, Minnesota.

PMID: 33605709
DOI: 10.1097/TA.0000000000003125

Abstract

Despite major improvements in the United States trauma system over the past two decades, prehospital trauma triage is a significant challenge. Undertriage is associated with increased mortality, and overtriage results in significant resource overuse. The American College of Surgeons Committee on Trauma benchmarks for undertriage and overtriage are not being met. Many barriers to appropriate field triage exist, including lack of a formal definition for major trauma, absence of a simple and widely applicable triage mode, and emergency medical service adherence to triage protocols. Modern trauma triage systems should ideally be based on the need for intervention rather than injury severity. Future studies should focus on identifying the ideal definition for major trauma and creating triage models that can be easily deployed. This narrative review article presents challenges and potential solutions for prehospital trauma triage.

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References

1. Pfeifer R, Halvachizadeh S, Schick S, Sprengel K, Jensen KO, Teuben M, Mica L, Neuhaus V, Pape HC. Are pre-hospital trauma deaths preventable? A systematic literature review. World J Surg . 2019;43(10):2438–2446.
1. MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med . 2006;354(4):366–378.
1. Tignanelli CJ, Vander Kolk WE, Mikhail JN, Delano MJ, Hemmila MR. Noncompliance with American College of Surgeons Committee on Trauma recommended criteria for full trauma team activation is associated with undertriage deaths. J Trauma Acute Care Surg . 2018;84(2):287–294.
1. Hashmi ZG, Haut ER, Efron DT, Salim A, Cornwell EE 3rd, Haider AH. A target to achieve zero preventable trauma deaths through quality improvement. JAMA Surg . 2018;153(7):686–689.
1. Zocchi MS, Hsia RY, Carr BG, Sarani B, Pines JM. Comparison of mortality and costs at trauma and nontrauma centers for minor and moderately severe injuries in California. Ann Emerg Med . 2016;67(1):56–67.e5.

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[1] Pfeifer R, Halvachizadeh S, Schick S, Sprengel K, Jensen KO, Teuben M, Mica L, Neuhaus V, Pape HC. Are pre-hospital trauma deaths preventable? A systematic literature review. World J Surg . 2019;43(10):2438–2446.

[2] Pfeifer R, Halvachizadeh S, Schick S, Sprengel K, Jensen KO, Teuben M, Mica L, Neuhaus V, Pape HC. Are pre-hospital trauma deaths preventable? A systematic literature review. World J Surg . 2019;43(10):2438–2446.

[3] MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med . 2006;354(4):366–378.

[4] MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med . 2006;354(4):366–378.

[5] Tignanelli CJ, Vander Kolk WE, Mikhail JN, Delano MJ, Hemmila MR. Noncompliance with American College of Surgeons Committee on Trauma recommended criteria for full trauma team activation is associated with undertriage deaths. J Trauma Acute Care Surg . 2018;84(2):287–294.

[6] Tignanelli CJ, Vander Kolk WE, Mikhail JN, Delano MJ, Hemmila MR. Noncompliance with American College of Surgeons Committee on Trauma recommended criteria for full trauma team activation is associated with undertriage deaths. J Trauma Acute Care Surg . 2018;84(2):287–294.

[7] Hashmi ZG, Haut ER, Efron DT, Salim A, Cornwell EE 3rd, Haider AH. A target to achieve zero preventable trauma deaths through quality improvement. JAMA Surg . 2018;153(7):686–689.

[8] Hashmi ZG, Haut ER, Efron DT, Salim A, Cornwell EE 3rd, Haider AH. A target to achieve zero preventable trauma deaths through quality improvement. JAMA Surg . 2018;153(7):686–689.

[9] Zocchi MS, Hsia RY, Carr BG, Sarani B, Pines JM. Comparison of mortality and costs at trauma and nontrauma centers for minor and moderately severe injuries in California. Ann Emerg Med . 2016;67(1):56–67.e5.

[10] Zocchi MS, Hsia RY, Carr BG, Sarani B, Pines JM. Comparison of mortality and costs at trauma and nontrauma centers for minor and moderately severe injuries in California. Ann Emerg Med . 2016;67(1):56–67.e5.

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Field-Triage, Hospital-Triage and Triage-Assessment: A Literature Review of the Current Phases of Adult Trauma Triage

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Field-Triage, Hospital-Triage and Triage-Assessment: A Literature Review of the Current Phases of Adult Trauma Triage

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