Overview :

In order to reduce overtriage of trauma patients, the categories used to classify trauma patients treated at the Ohio State University Hospitals was modified in 1997. This resulted in better utilization of resources without adversely affecting patient outcome.

Categories for triaging trauma patients:

(1) Category 1: most serious injured, based on physiologic and/or anatomic criteria

(2) Category 2: less injured, including the patient at risk for significant injury based on mechanism of injury

(3) other: those not meeting criteria for Categories 1 or 2, handled as consultations without a trauma alert

Category 1 - one or more of the following:

(1) hemodynamic instability (blood pressure < 90 mm Hg; heart rate > 120 beats/minute)

(2) respiratory distress, mechanical ventilation, unstable airway

(3) altered level of consciousness, with Glasgow Coma Score <= 8

(4) penetrating wounds to head, neck, chest, abdomen, groin or extremity with neurovascular compromise

(5) open or unstable pelvis fracture

(6) judgment of the ED physician

Category 2 - one or more of the following:

(1) ejection from automobile

(2) fatality in same passenger compartment

(3) extraction time > 20 minutes

(4) falls > 20 feet (6 meters)

(5) rollover motor vehicle crash

(6) high-speed automobile crash

(7) automobile pedestrian-bicycle injury

(8) motorcycle crash at > 20 mph

(9) altered level of consciousness, with Glasgow Coma Score 9 – 13

(10) stable patient with multisystem trauma

(11) open extremity fractures

(12) multiple closed extremity fractures

(13) traumatic amputations

(14) burns with associated trauma

(15) air medical scene run

(16) judgment of the ED physician

Response to trauma patient:

(1) category 1: full trauma team

(2) category 2: partial trauma team headed by a senior resident

(3) other: 1 or more consultants

Cook CH, Muscarella P, et al. Reducing overtriage without compromising outcomes in trauma patients. Arch Surg. 2001; 136: 752-756.