System compliance with out-of-hospital trauma triage criteria.

BACKGROUND Emergency Medical Services (EMS) providers are the initial link to a trauma care system. Previous studies have demonstrated poor compliance with trauma triage by EMS personnel. We sought to determine the proportion of adult EMS cases within a large state meeting Trauma Triage Criteria (TTC) who are ultimately cared for in trauma centers. METHODS Merged EMS and hospital discharge records for 1996 were examined. All adult acute trauma cases were included. Single-system burns and late effects of injury were excluded. RESULTS Nine thousand one hundred seventy-four adult cases had at least one TTC, and 60.1% of these patients were transported to a non-trauma center (NTC) and 74.6% of cases with an Injury Severity Score > 15 and one TTC were taken to trauma centers. Analyzing two large urban counties, 58.2% and 27.0% of all TTC cases were still taken to NTC hospitals. CONCLUSION A significant proportion of seriously injured patients meeting TTC were transported by EMS personnel to NTCs.

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