A Prospective Evaluation of Field Categorization of Trauma Patients

Abstract
We prospectively evaluated the efficacy of comprehensive field triage in 8,891 trauma patients transported to trauma centers in Dade County, Florida, over a 1-year period ending in September 1986. There were 5,685 males (63.9%) and 3,206 females (36.1%) with a mean age of 32.4 $pM 18.4 years. The overall accuracy for identifying severe injury for the entire group was 30.2%. A Trauma Score $le;12 was the most accurate predictor of severe injury. Of 669 patients in this group, 617 (92.2%) sustained severe injury and 361 died (54.0%). High-speed (>40 m.p.h.) motor vehicle accident was the most common reason for triage; however, of 2,277 in this group 201 patients (9.0%) had severe injury and four patients (0.2%) died. Only nine deaths (0.9%) occurred in 1,004 patients with penetrating trauma whose Trauma Scores were greater than 12. Of the 8,891 patients 4,791 (53.9%) had moderate to severe injury. The overtriage rate was therefore 46.1% using this field categorization system.