THE TRAUMA SCORES, CRAMS SCALES, AND MECHANISMS OF INJURY OF 500 TRAUMA PATIENTS WERE EVALUATED FOR THEIR ABILITY TO IDENTIFY A SERIOUSLY INJURED PATIENT. SERIOUS INJURY WAS DEFINED AS ONE OF THE FOLLOWING: INJURY SEVERITY SCORE (ISS) >15, OR EMERGENCY-ROOM TRAUMA SCORE LESS THAN OR EQUAL TO 14, OR INJURIES REQUIRING >3 DAYS HOSPITALIZATION, OR DEATH. WITH THE ADDITION OF SPECIFIC MECHANISMS OF INJURY (AUTO VS PEDESTRIAN AT >5 MPH, MOTOR VEHICLE ACCIDENT AT >40 MPH, MOTORCYCLE ACCIDENT AT >20 MPH, OR A MAJOR ASSAULT), THE SENSITIVITY OF A FIELD TRAUMA SCORE OF <14 COULD BE IMPROVED FROM 45% TO 75%, WITH A REASONABLE SPECIFICITY OF 40%. WITH THESE SAME MECHANISMS, THE SENSITIVITY OF A CRAMS SCALE OF LESS THAN OR EQUAL TO 8 INCREASED FROM 66% TO 93%, WITH A SPECIFICITY OF 30%. THE ADDITION OF THESE MECHANISMS OF INJURY TO STANDARD FIELD TRIAGE SCORING APPEARS TO IMPROVE THE IDENTIFICATION OF SERIOUSLY INJURED PATIENTS WHILE RETAINING AN ACCEPTABLE LEVEL OF OVERTRIAGE.
Abstract