From the Department of Surgery (R.M., B.S.K., P.M., D.M., M.d.M.), Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Surgery (P.J.), Indiana University, Indianapolis, Indiana; Department of Surgery (M.H.), University of Michigan, Ann Arbor, Michigan; Department of Surgery (K.H.), Duke University, Durham, North Carolina; Department of Surgery (T.P.), University of Texas Health Science Center, Houston, Texas; Department of Surgery (C.T.), and Institute for Health Informatics (C.T.), University of Minnesota, Minneapolis; and Department of Surgery (C.T.), North Memorial Health Hospital, Robbinsdale, Minnesota.
J Trauma Acute Care Surg. 2021 Jun 1;90(6):e138-e145. doi: 10.1097/TA.0000000000003125.
Despite major improvements in the United States trauma system over the past two decades, prehospital trauma triage is a significant challenge. Undertriage is associated with increased mortality, and overtriage results in significant resource overuse. The American College of Surgeons Committee on Trauma benchmarks for undertriage and overtriage are not being met. Many barriers to appropriate field triage exist, including lack of a formal definition for major trauma, absence of a simple and widely applicable triage mode, and emergency medical service adherence to triage protocols. Modern trauma triage systems should ideally be based on the need for intervention rather than injury severity. Future studies should focus on identifying the ideal definition for major trauma and creating triage models that can be easily deployed. This narrative review article presents challenges and potential solutions for prehospital trauma triage.
尽管美国创伤系统在过去二十年中取得了重大进展,但院前创伤分诊仍然是一个重大挑战。分诊不足与死亡率增加有关,而过度分诊则导致资源的大量浪费。美国外科医师学会创伤委员会制定的分诊不足和过度分诊的基准并未得到满足。存在许多适当的现场分诊障碍,包括缺乏对重大创伤的正式定义、缺乏简单且广泛适用的分诊模式,以及急救医疗服务对分诊协议的遵守。理想情况下,现代创伤分诊系统应该基于干预的需要,而不是伤害的严重程度。未来的研究应集中于确定重大创伤的理想定义,并创建可以轻松部署的分诊模型。本文对院前创伤分诊的挑战和潜在解决方案进行了综述。