Brown et al reported the Air Medical Prehospital Triage (AMPT) score for field evaluation of a trauma patient. This can help to identify a patient who may benefit from helicopter transport. The authors are from the University of Pittsburgh and the University of Rochester.
Patient selection: trauma patient in the field
Parameters:
(1) Glasgow coma scale (GCS)
(2) respiratory rate in breaths per minute
(3) unstable chest wall fractures (any chest wall instability or deformity including flail chest or multiple rib fractures)
(4) suspected hemothorax or pneumothorax (absence of breath sounds on affected hemithorax AND objective signs of respiratory distress such as cyanosis or Sp)2 < 92%)
(5) paralysis
(6) multisystem trauma (>=3 anatomic body regions injured)
(7) any 1 physiologic criterion AND any 1 anatomic criterion present from the American College of Surgeons Committee on Trauma (ACS-COT) national field triage guidelines. These are similar to the "2011 Recommendations of the National Expert Panel for Field Triage of an Injured Patient".
Parameter |
Finding |
Points |
Glasgow Coma Scale |
14 or 15 |
0 |
|
3 to 13 |
1 |
respiratory rate |
< 10 |
1 |
|
10 to 29 |
0 |
|
> 29 |
1 |
unstable chest wall fractures |
no |
0 |
|
yes |
1 |
suspected hemo- or pneumothorax |
no |
0 |
|
yes |
1 |
paralysis |
no |
0 |
|
yes |
1 |
multisystem trauma |
no |
0 |
|
yes |
1 |
physiologic and anatomic criteria |
0 anatomic OR 0 physiologic criteria |
0 |
|
>= 1 anatomic AND >= 1 physiologic criteria |
1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 2 indicates helicopter transport is appropriate.
Performance:
• The adjusted odds ratio for survival if triaged to air transport AND if transported by air was 1.3.
Specialty: Surgery, orthopedic, Emergency Medicine