The sensitivity of pre-hospital and in-hospital tools for the identification of major trauma patients presenting to a major trauma centre

J R Nav Med Serv. 2013;99(1):16-9.


The identification of major trauma patients before arrival in hospital allows the activation of an appropriate trauma response. The Wessex triage tool (WTT) uses a combination of anatomical injury assessment and physiological criteria to identify patients with major trauma suitable for triage direct to a major trauma centre (MTC), and has been adopted by the South-West Peninsula Trauma Network (PTN). A retrospective database review, using the Trauma Audit Research Network (TARN) database, was undertaken to identify a population of patients presenting to Derriford Hospital with an injury severity score (ISS) >15. The WTT was then applied to this population to identify the sensitivity of the tool. The sensitivity of the WTT at identifying patients with an ISS> 15 was 53%. One of the reasons for this finding was that elderly patients who are defined as having major trauma due to the nature of their injuries, but who did not have a mechanism to suggest they had sustained major trauma (such as a fall from standing height), were not identified by these triage tools. The implications of this are discussed.

MeSH terms

  • Aged
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity
  • Trauma Centers*
  • Triage / methods*
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / etiology