• Natalia Kouzminova, Clayton Shatney, Erin Palm, Michael McCullough, and John Sherck.
• Division of Trauma, Department of Surgery, Santa Clara Valley Medical Center, San Jose, California 95128, USA.
• J Trauma. 2009 Oct 1;67(4):829-33.

BackgroundBy using current American College of Surgeons trauma center triage criteria, 52% of patients transported to our level I trauma center are discharged home from the emergency department (ED). Because the majority of our trauma transports were based solely on mechanism of injury, we instituted, in 1990, a two-tiered trauma team activation system. Patients are triaged into major and minor trauma alert categories based on prehospital provider information. For minor trauma patients, respiratory therapy, operating room staff, and blood bank do not respond. The current study evaluated this triage system.MethodsTrauma registry data on all trauma activations from 1998 to 2007 were analyzed.ResultsThere were 20,332 trauma activations: 5,881 were major trauma, 14,451 minor trauma. The mean Injury Severity Score in major versus minor patients was significantly different (11.7 vs. 3.6, p < 0.0001). Significant differences (p < 0.0001) were also noted for all other markers of serious injury: Injury Severity Score >16, ED blood pressure <90, Glasgow Coma Score ConclusionA two-tiered trauma activation system identifies patients who require a full trauma team response and may result in a more effective use of trauma center resources.

27 keywords...

hide…