Roden-Foreman et al reported the Need for Trauma Intervention (NFTI) for the identification of major trauma. It is somewhat retrospective in scope. The authors are from Baylor University Medical Center in Dallas.

Patient selection: trauma


Criteria for major trauma:

(1) transfusion of packed RBC within the first 4 hours of arrival

(2) going to the OR within 90 minutes of arrival

(3) going from the ED to interventional radiology

(4) admission to the intensive care unit (ICU) from the ED, or total ICU length of stay >= 3 calendar days

(5) receiving mechanical ventilation for reasons other than procedural anesthesia within the first 3 days

(6) death within 60 hours of hospital arrival



• Death within 60 hours may need to be modified to identify trauma-related deaths and to exclude those due to comorbid conditions. The same may need to be applied to the start of mechanical ventilation.

• Calendar days are based on the date of admission and date of action, with the date of admission designated 1.


total score =

= SUM(criteria present)



• minimum score: 0

• maximum score: 6

• A score >= 1 is NFTI-positive (major trauma). The patient is considered highly likely to need trauma activation, regardless of the ISS.

• A score =0 is NFTI negative.

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