The Trauma Score as a Triage Tool in the Prehospital Setting

John A. Morris, Paul S. Auerbach, Gregory A. Marshall, Raymond F. Bluth, Lynda G. Johnson, Donald Trunkey

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Implementation of a regional trauma care system requires a field triage tool that identifies the severely injured patient and transports him to a trauma center, while preserving the flow of minimally injured patients to community hospitals. We prospectively tested the Trauma Score (TS) as a field triage tool and evaluated its accuracy against that of the Injury Severity Score (ISS), calculated after the patients’ injuries were fully defined. During an 18-month period, 1106 patients admitted to the trauma center at San Francisco General Hospital had a TS determined in the field (TS1) and on arrival at the emergency department. A TS1 of 14 or less defined a subgroup of 222 patients in whom 93% of the deaths occurred. Using an ISS of 20 or more as an indicator of life-threatening injury, we determined the predictive value of TS1. There were 66 false-negatives (ISS, ≥20; TS1, 15 or 16) and 107 false-positives (ISS, 1, ≤14). Using a prehospital TS of 14 or less as an indicator of serious injury, only 20% of a major urban trauma population would qualify for diversion to a trauma center.

Original languageEnglish (US)
Pages (from-to)1319-1325
Number of pages7
JournalJAMA - Journal of the American Medical Association
Volume256
Issue number10
DOIs
StatePublished - Sep 12 1986
Externally publishedYes

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Triage
Injury Severity Score
Wounds and Injuries
Trauma Centers
Urban Population
San Francisco
Community Hospital
General Hospitals
Hospital Emergency Service

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Trauma Score as a Triage Tool in the Prehospital Setting. / Morris, John A.; Auerbach, Paul S.; Marshall, Gregory A.; Bluth, Raymond F.; Johnson, Lynda G.; Trunkey, Donald.

In: JAMA - Journal of the American Medical Association, Vol. 256, No. 10, 12.09.1986, p. 1319-1325.

Research output: Contribution to journalArticle

Morris, John A. ; Auerbach, Paul S. ; Marshall, Gregory A. ; Bluth, Raymond F. ; Johnson, Lynda G. ; Trunkey, Donald. / The Trauma Score as a Triage Tool in the Prehospital Setting. In: JAMA - Journal of the American Medical Association. 1986 ; Vol. 256, No. 10. pp. 1319-1325.
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