The trauma triage rule: a new, resource-based approach to the prehospital identification of major trauma victims

Ann Emerg Med. 1990 Dec;19(12):1401-6. doi: 10.1016/s0196-0644(05)82608-3.


Study objective: To develop a new trauma decision rule.

Design: Retrospective clinical review.

Setting: Level I trauma center.

Type of participants: 1,004 injured adults.

Measurements and main results: A new trauma decision rule was derived from 1,004 injured adult patients using a new operational definition of major trauma. The rule, termed the Trauma Triage Rule, defines a major trauma victim as any injured adult patient whose systolic blood pressure is less than 85 mm Hg; whose motor component of the Glasgow Coma Score is less than 5; or who has sustained penetrating trauma of the head, neck, or trunk. Using the operational definition of major trauma, the rule had a sensitivity of 92% and a specificity of 92% when tested on the 1,004-patient cohort.

Conclusion: The Trauma Triage Rule may significantly reduce overtriage while only minimally increasing undertriage. This approach must be validated prospectively before it can be used in the prehospital setting.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure
  • California
  • Emergencies
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Trauma Centers / organization & administration*
  • Triage / organization & administration*
  • Wounds and Injuries / classification
  • Wounds and Injuries / mortality
  • Wounds and Injuries / physiopathology*