Proximal Penetrating Extremity Injuries – An Opportunity to Decrease Overtriage?

ABSTRACTBackgroundPenetrating injuries to the extremity proximal to the elbow or knee are anatomic criteria for full trauma team activation by the American College of Surgeon’s Committee on Trauma standards. This criterion lacks objective evidence-based support. Overtriage of trauma team activation may result in excessive costs and resource burden at trauma centers. We hypothesized that full trauma team activation for penetrating injuries to the proximal extremities by anatomic criteria alone may lead to significant overtriage.MethodsA 3-year retrospective review (2013-2015) was completed of all patients evaluated at an urban level I trauma center with isolated penetrating extremity injuries. Data included the number of full and limited trauma team activations as well as criterion met, ISS, injury, limb characteristics, and disposition. Overtriage was defined as full trauma team activation for an ISS ≤ 15, with a goal rate

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