Transport to Trauma Center or Closest ED? It Depends on Age.

Paramedics use general criteria to decide whether an adult trauma patient should be transported to a regional trauma center or the closest emergency department (ED). The state of Ohio established geriatric-specific trauma triage criteria in 2008, and these investigators compared patient dispositions before and after the change.

They studied 101,577 trauma patients (33% aged ≥70) seen from 2006 to 2011. The geriatric criteria, intended for patients aged ≥70, had lower thresholds for transport to a trauma center — for example, systolic blood pressure ≤100 mm Hg (vs. ≤90 mm Hg in the general adult criteria), pedestrian struck by a motor vehicle (no such rule in the general adult criteria). Applying the geriatric criteria resulted in increased s…