Trauma Triage Criteria -Adult and Pediatric

Patient unstable - Need for immediate trauma resuscitation or immediate OR

Team includes:  Trauma Surgeon, ED MD, Anesthesia, ED RNs, ICU RN, Lab, Xray, CT Tech, Respiratory, Pharmacy, Scribe, House Supervisor, Social Services, Admissions

• Intubated patients
• Threatened or compromised airway
• Pneumothorax or ventilation compromise
• Grunting or stridor in child
• Respiratory rate < 10 or > 29 (< 20 infant < 1 yr)
• Flail chest

Circulation

• Systolic blood pressure <90
• Transfer patients receiving blood to maintain vital signs

Disability

• GCS < 12
• Open or depressed skull fracture
• Paralysis or focal neurologic deficit

• Burns >20% BSA or to head, face, genitalia
• High voltage injury (including lightening) 
• Penetrating injury to torso, neck, head,

        or proximal to elbow or knee   
 


Other

• Unstable pelvic fracture
• Bilateral femur fractures
• Open fractures in multiple trauma setting
• Pulseless extremity / threatened limb
• Traumatic amputation / mangled limb / crushed / degloved / impaled
• MD or RN discretion

Patient stable – Mechanism suggests possible significant injury – need expedited evaluation

Team includes:  ED MD, ED RN, Lab, X-ray, Admissions

• Isolated open fractures
• 2 or more proximal long bone fractures

         (bilateral femur fractures = Full Team)

• Subcutaneous emphysema
• Possible spinal fractures without CNS

         involvement

• Maxillofacial trauma without airway                

        compromise 

Mechanism of Injury

• Auto vs pedestrian / bicycle

• Death in same collision

• Thrown from horse
• MVC w/speed �� 45 MPH
• Motorcycle / ATV / snowmobile crash

• Fall > 15 feet

              Pediatric falls > twice their height

• Age > 65 or < 5
• Multiple co-morbidities
• Blood thinners or other bleeding/clotting disorders
• Ejection from vehicle / rollover
• Major auto deformity, intrusion into occupant compartment > 12 inches
• Extrication > 20 minutes
• Pregnancy > 20 wks
• Hypo or hyperthermic symptoms

Other

• Stable transfers from outside hospital ED with injuries resulting from traumatic mechanism

 (ED to ED or in-patient < 24 hours)