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Field triage : ウィキペディア英語版
Field triage

Field triage is the process by which emergency medical services providers decide on the destination for the injured subject.
Each year, the approximately 1 million emergency medical services (EMS) providers have a substantial impact on the care of injured persons and on public health in the United States. The profound importance of daily on-scene triage decisions made by EMS providers is reinforced by CDC-supported research that shows that the overall risk of death was 25 percent lower when care was provided at a Level I trauma center than when it was provided at a non-trauma center. Not all injured patients can or should be transported to a Level I trauma center. Other hospitals can effectively meet the needs of patients with less severe injuries, and may be closer to the scene. Transporting all injured patients to Level I centers—regardless of injury severity—limits the availability of Level I trauma center for those patients who really need the level of care provided at those facilities. Proper field triage ensures that patients are transported to the most appropriate healthcare facility that best matches their level of need.〔(Injury Prevention and Control: Field Triage )〕
==Background==

In 1976, American College of Surgeons (ACS) ACS-COT began publishing resource documents to provide guidance for designation of facilities as trauma centers and appropriate care of acutely injured patients.〔
Before this guidance appeared, trauma victims were transported to the nearest hospital, regardless of the capability of that hospital, and often with little prehospital intervention.〔Centers for Disease Control and Prevention. Guidelines for Field Triage of Injured Patients: Recommendations of the National Expert Panel of Field Triage. MMWR 2008;57 (No. RR-1):().〕〔Mackersie RC. History of trauma field triage development and the American College of Surgeons criteria. Prehosp Emerg Care 2006;10:287--94.〕
ACS-COT regularly revised the resource document, which included the Decision Scheme. During each revision, the Decision Scheme was evaluated by a subcommittee of ACS-COT, which analyzed the available literature, considered expert opinion, and developed recommendations regarding additions and deletions to the Decision Scheme. Final approval of the recommendations rested with the ACS-COT Executive Committee. Since its initial publication in 1986,〔American College of Surgeons. Hospital and prehospital resources for the optimal care of the injured patient: appendices A through J. Chicago, IL: American College of Surgeons; 1986.〕 the Decision Scheme has been revised four times: in 1990,〔American College of Surgeons. Resources for the optimal care of the injured patient: 1990. Chicago, IL: American College of Surgeons; 1990.〕 1993,〔American College of Surgeons. Resources for the optimal care of the injured patient: 1993. Chicago, IL: American College of Surgeons; 1993.〕 1999〔American College of Surgeons. Resources for the optimal care of the injured patient: 1999. Chicago, IL: American College of Surgeons; 1999.〕 and 2006.〔American College of Surgeons. Resources for the optimal care of the injured patient: 2006. Chicago, IL: American College of Surgeons; 2006.〕
In recent years, CDC has taken an increasingly active role in the intersection between public health and acute injury care, including the publication in 2005 of an injury care research agenda.〔Centers for Disease Control and Prevention. CDC acute injury care research agenda: guiding research for the future. Atlanta, GA: US Department of Health and Human Services, CDC; 2005. Available at http://www.cdc.gov/ncipc/dir/ARagenda.htm.〕 In 2005, with financial support from the National Highway Traffic Safety Administration (NHTSA), CDC convened a series of meetings of the National Expert Panel on Field Triage (the Panel) to guide the 2006 revision of the Decision Scheme. The Panel brought representatives with additional expertise to the revision process (e.g., persons in EMS, emergency medicine, public health, the automotive industry, and other federal agencies).〔 The Panel had multiple objectives, including providing a vigorous review of the available evidence supporting the Decision Scheme, assisting with the dissemination of the revised scheme and the underlying rationale to the larger public health and acute injury care community, emphasizing the need for additional research in field triage, and establishing an evidence and decision base for future revisions. A major outcome of the Panel's meetings was the creation of the 2006 Field Triage Decision Scheme: The National Trauma Triage Protocol.〔

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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