Att A - Field Triage Guidelines

FIELD TRIAGE DECISION SCHEME:
THE NATIONAL TRAUMA TRIAGE PROTOCOL

1

Measure vital signs and level of consciousness
Glasgow Coma Scale
Systolic blood pressure
Respiratory rate

< 14 or
< 90 or
< 10 or > 29 (< 20 in infant < one year)

YES

NO

Take to a trauma center. Steps 1 and 2 attempt to identify
the most seriously injured patients. These patients should be
transported preferentially to the highest level of care within
the trauma system.

2

Assess anatomy of injury

• All penetrating injuries to head, neck, torso, and extremities
proximal to elbow and knee
• Flail chest
• Two or more proximal long-bone fractures
• Crushed, degloved, or mangled extremity
• Amputation proximal to wrist and ankle
• Pelvic fractures
• Open or depressed skull fracture
• Paralysis

YES
Take to a trauma center. Steps 1 and 2 attempt to identify
the most seriously injured patients. These patients should be
transported preferentially to the highest level of care within
the trauma system.

3

NO

Assess mechanism of injury and
evidence of high-energy impact

Falls
• Adults: > 20 ft. (one story is equal to 10 ft.)
• Children: > 10 ft. or 2-3 times the height of the child
High-Risk Auto Crash
• Intrusion: > 12 in. occupant site; > 18 in. any site
• Ejection (partial or complete) from automobile
• Death in same passenger compartment
• Vehicle telemetry data consistent with high risk of injury
Auto v. Pedestrian/Bicyclist Thrown, Run Over, or with
Significant (> 20 MPH) Impact
Motorcycle Crash > 20 MPH

YES
Transport to closest appropriate trauma center, which
depending on the trauma system, need not be the highest
level trauma center.

4

NO
Assess special patient or
system considerations

Age
• Older Adults: Risk of injury death increases after age 55
• Children: Should be triaged preferentially to pediatric-capable
trauma centers
Anticoagulation and Bleeding Disorders
Burns
• Without other trauma mechanism: Triage to burn facility
• With trauma mechanism: Triage to trauma center
Time Sensitive Extremity Injury
End-Stage Renal Disease Requiring Dialysis
Pregnancy > 20 Weeks
EMS Provider Judgment

YES
Contact medical control and consider transport to a trauma
center or a specific resource hospital.

NO
Transport according to protocol

When in doubt, transport to a trauma center.
For more information, visit: www.cdc.gov/FieldTriage
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention