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 Release 22.0, Sept. 2008
 
Chapter : ch29. Trauma & Emergency Medicine Section : Triage of the Trauma Patient
  Criteria of MacKenzie et al for Triage of a Patient to a Trauma Center Based on the Abbreviated Injury Scale (AIS)

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Overview :

MacKenzie et used several clinical parameters including age, Abbreviated Injury Scale (AIS) and type of injury to determine if a patient should be triaged to a trauma center or treated at the local community hospital. The authors are from the University of Maryland and the Johns Hopkins University.

 

Regions for the AIS:

(1) external

(2) head

(3) neck

(4) thorax

(5) abdominal or pelvic contents

(6) spine

(7) extremities

 

Injury Severity

Abbreviated Injury Score

minor injury

1

moderate injury

2

severe but not life-threatening

3

potentially life-threatening but survival likely

4

critical with uncertain survival

5

unsurvivable injury

6

severity unknown

9

 

Triage rules:

 

Maximum AIS

Age

Other

Triage To

<= 2 in <= 2 regions

any

 

non-trauma

>= 2 in >= 3 regions

any

 

trauma

>=3 in >= 1 region

< 5 years

 

trauma

>=3 in >= 1 region

>= 55 years

not closed hip fracture; fall from height

trauma

3 in 1 body region

>= 55

closed hip fracture; not fall from height

non-trauma

3 in 1 or 2 body regions

5 - 54 years

not excluded

non-trauma

3 in 1 or 2 body regions

5 - 54 years

excluded

trauma

>= 4 in >= 1 region

any

 

trauma

>=5 burn

 

 

burn center

>=4 burn and >=5 in other regions

 

 

trauma then burn

 

where:

• Vassar et al modified the table by (1) using AIS >= 3 in >= 3 body regions for second entry (not used) and (2) fall from height data (used).

• I modified the burn criteria in the implementation, changing from >= 5 to >= 4.

 

Excluded for AIS 3 in 1 body region:

(1) AIS 3 to head, spine, or thorax

(2) AIS 3 to abdomen with hemorrhage (hypovolemia producing)

(3) AIS 3 pelvic fracture

(4) AIS 3 crush injury in extremity

(5) AIS 3 extremity injury with major vascular involvement

 

  References:

American Association for Automative Medicine. Proceedings of the 31st Annual Conference in New Orleans, Louisiana. September 28-30, 1987, page viii.

MacKenzie EJ, Steinwachs DM, Ramzy AI. Evaluating perfomance of statewide regionalized systems of trauma care. J Trauma. 1990; 30: 681-688 (page 682).

Vassar MJ, Holcroft JJ, et al. Fractures in access to and assessment of trauma systems. J Am Coll Surgeons. 2003; 197: 717-725.

 

 

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