Characterizing Re-Triage Guidelines: A Scoping Review of States’ Rules and Regulations

This research looks at the rules each state has for transferring severely injured patients from smaller hospitals to major trauma centers. These transfers are called re-triage. Knowing these rules helps improve care for trauma patients. Many severely injured patients initially go to hospitals that aren't major trauma centers. If those patients need more specialized care, they must be transferred to a trauma center. This study looks at how states decide which patients need that transfer. The study found that many states don't have clear guidelines for these transfers, and the guidelines that do exist vary widely. By understanding these differences, states can improve their systems for getting patients to the right level of care.

• 1
  Only 22 out of 50 US states (44%) have established re-triage guidelines for emergency inter-facility transfer of trauma patients.
• 2
  Common criteria for re-triage included head trauma (91% of states with guidelines), spinal cord injury (82%), chest injury (77%), and pelvic injury (73%).
• 3
  Vital signs criteria frequently used were Glasgow Coma Score (GCS) with a median of 13, blood pressure with a median of less than 90 mmHg, and respiratory rate with all using 10 respirations/minute.