Ability of the Physiologic Criteria of the Field Triage Guidelines to Identify Children Who Need the Resources of a Trauma Center

Figures & data

Table 1. Physiologic criteria of the field triage guidelines

Glasgow Coma Scale (GCS) ≤ 13

Systolic Blood Pressure (SPB) <90

Respiratory Rate (RR) <10 or >29 (for an infant less than 1 year, <20) or the need for ventilatory support

Table 2. Comparison of included and missed patients

	Included	Missed
	(n = 5594)	(n = 2696)^*
Age in Years (mean)	7.5 ± 4.8	7.2 ± 4.9
Male Gender	3,365 (60.2%)	1,570 (58.2%)
Mechanism of Injury
Assault, Gun Shot, and Stabbing	216 (3.9%)	116 (4.3%)
Bicyclist Struck	128 (2.3%)	43 (1.6%)
Burn	104 (1.9%)	31 (1.1%)
Fall	1,915 (34.2%)	844 (31.3%)
Motor Vehicle Crash	1,206 (21.6%)	709 (26.3%)
Motorcycle Crash	21 (0.4%)	2 (0.1%)
Pedestrian Struck	368 (6.6%)	161 (6.0%)
Sports Injury	429 (7.7%)	165 (6.1%)
Other	1,207 (21.6%)	625 (23.2%)
Percent Admitted	15.1%	17.7%
Percent Death	0.5%	0.4%

^* Specific data on missed patients for each variable was unavailable for 1 of the 2,697 patients.

Specific data on the included patients was missing age for 7 patients and gender for 3 patients.

Table 3. Accuracy of EMS identified physiologic criteria in predicting trauma center need

	Met physiologic	Did not meet
	criteria	physiologic criteria
Needed trauma center resources	137	142
Did not need trauma center resources	935	4,380

Table 4. Accuracy of individual physiologic criterion in predicting trauma

	GCS ≤ 13	SBP < 90	RR
Under-triage Rate	67%	87%	69%
Over-triage Rate	2%	4%	14%
+Likelihood	14.3 (95% CI:	3.5 (95% CI:	2.2 (95% CI:
Ratio	11.2–18.3)	2.5–5.1)	1.8–2.6)

Table 5. Comparison of EMS and ED vital signs

		EMS Positive	EMS Negative
GCS < 14 N = 2,249	ED Positive	55	31
	ED Negative	47	2,116
SBP < 90 N = 3,754	ED Positive	29	81
	ED Negative	121	3,523
RR < 10 or > 29	ED Positive	278	332
N = 4,697	ED Negative	406	3,681

Not all of the cases had complete emergency department data.

Table 6. Percent of cases with missing data by age

	Number
Age	of Cases	GCS (%)	SBP (%)	RR (%)
<1	329	14	79	11
1–4 years	1,569	7	46	8
5–9 years	1,431	3	7	3
10–15 years	2,265	2	2	2
Total	5,594	4	20	5