Step One: Physiologic Criteria
• Add a lower limit threshold for respiratory rate in infants (aged 18 inches at any site
— partial or complete ejection from the vehicle
— death of another passenger in the same passenger compartment
— vehicle telemetry data consistent with high risk for injury
• Revise “auto-pedestrian/auto-bicycle injury with significant (>5 mph) impact” and “pedestrian thrown or run over” to
“Auto vs. pedestrian/bicyclist thrown, run over, or with significant (>20 mph) impact”
• Revise “motorcycle crash >20 mph with separation of rider from bike” to “motorcycle crash >20 mph”
• Remove “initial speed >40 mph, major auto deformity >20 inches, extrication time >20 min, and rollover”
Step Four: Special Considerations
• Add “time-sensitive extremity injury, end-stage renal disease requiring dialysis, and Emergency Medical Service provider
judgment”
• Add burns from Step Two
— burns without other trauma mechanism: triage to burn facility
— burns with trauma mechanism: triage to trauma center
• Clarify aged 55 years to read:
— older adults: risk of injury death increases after age 55 years
— children: should be triaged preferentially to pediatric-capable trauma centers
• Change “patient with bleeding disorder or patient on anticoagulants” to “anticoagulation and bleeding disorders”
• Change “pregnancy” to “pregnancy >20 wks”
• Remove “cardiac disease, respiratory disease, insulin-dependent diabetes, cirrhosis, morbid obesity, and immunosuppressed
patients”