Purpose of Review

To summarize evaluations of physiologic measures that can be used by emergency medical services personnel to identify patients at high risk of serious injury and inform decisions about the level of trauma care needed.

Key Messages

• Studies examined individual measures and combinations for trauma triage, including systolic blood pressure, heart rate, shock index, lactate, base deficit, respiratory rate, oxygen saturation, and need for airway support.
• Included measures have:

  • Low sensitivities, so normal values on the physiologic measure (a negative test) cannot be used with confidence to determine that patients are not seriously injured.
  • High specificities, meaning abnormal values on the physiologic measure (positive test) are unlikely in patients not seriously injured.
• Combinations of physiologic measures with measures of consciousness may perform better than physiologic measures alone, but feasibility and reliability of performance in the field are significant challenges.
• Measures perform less well in children and older people. Changes in cut-points for these age groups may improve performance but have not yet been rigorously evaluated.
• Research is needed on the feasibility of combination measures and how precisely physiologic parameters are measured, including use of technology.
• Researchers should use standard definitions of serious injury to permit comparisons across studies and measures.