Trauma Triage Decision Tool (CDC)
ACS 2021 National Field Triage of Injured Patients.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Step 1: GCS <= 13
- Yes
Result: Highest-level trauma center (Step 1).
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Step 1: GCS <= 13
- Step 1: SBP < 110 mmHg (adult) or signs of shock (pediatric)
- Step 1: respiratory rate < 10 or > 29, or respiratory distress
- Step 2: penetrating injury to head, neck, or torso
- Step 2: amputation proximal to wrist or ankle
- Step 2: suspected pelvic fracture
- Step 2: two or more proximal long-bone fractures
- Step 2: crushed, degloved, mangled, or pulseless extremity
The other 12 fields
- Step 2: chest-wall instability or deformity (e.g. flail chest)
- Step 2: open or depressed skull fracture
- Step 2: paralysis
- Step 3: fall > 20 ft (adult) or > 10 ft / 2-3x height (pediatric)
- Step 3: high-risk motor-vehicle crash
- Step 3: auto vs pedestrian/bicyclist thrown, run over, or > 20 mph impact
- Step 3: motorcycle crash > 20 mph
- Step 4: older adult
- Step 4: pediatric patient
- Step 4: anticoagulant or bleeding-disorder
- Step 4: pregnancy > 20 weeks
- Step 4: burns
What this is
Step a single injured patient through the CDC National Guidelines for the Field Triage of Injured Patients - the four-step decision scheme that EMS uses to decide whether to transport to a Level I or II trauma center, a Level III/IV center, or the nearest appropriate facility. The four steps in order: physiologic criteria (GCS, SBP, respiratory rate), anatomic criteria (penetrating injuries proximal to elbow/knee, flail chest, pelvic fracture, paralysis, etc.), mechanism criteria (fall height, vehicle telemetry, ejection), and special considerations (age, anticoagulation, pregnancy, EMS judgment). Sophie Well returns the destination tier and the rule that triggered it.
When to use it
Use this on-scene or during transport when destination is in question, on training shifts to verify your local protocol matches the national guideline, or in QA review of a trauma transport decision. The CDC guideline is the federal scaffold; every state and EMS region overlays its own destination rules, trauma-system catchment maps, and pediatric routing - your local protocol always wins on the truck. The triage decision is also iterative: a patient who looks stable on initial contact and decompensates en route should be re-triaged and the destination escalated, with the receiving facility notified.
How this is calculated
Newgard CD, Fischer PE, Gestring M, et al. National guideline for the field triage of injured patients, 2021. J Trauma Acute Care Surg. 2022;93(2):e49-e60. (American College of Surgeons Committee on Trauma; supersedes CDC MMWR 2011;61(RR-1) field-triage guidance.) Read the source ↗
Source: CDC Field Triage Guidelines
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.
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