The CDC Field Triage Decision Scheme Made Simple

The CDC Field Triage Decision Scheme tells you which trauma patient goes to a trauma center and which can go to the closest hospital. Every EMS system uses a variant, and the NREMT tests the underlying logic.

Step 1 — Physiologic criteria (any = trauma center)

• GCS ≤ 13
• Systolic BP < 110 for age > 65, < 90 for others
• Respiratory rate < 10 or > 29 (or needing ventilatory support)

Step 2 — Anatomic criteria

• Penetrating injury to head, neck, torso, or proximal extremities
• Flail chest
• Two or more proximal long-bone fractures
• Amputation proximal to wrist or ankle
• Pelvic fracture, open or depressed skull fracture, paralysis

Step 3 — Mechanism

• Falls > 20 ft adults / > 10 ft or 2–3x height in kids
• High-risk auto crash (intrusion > 12 in occupant site, ejection, death of another occupant)
• Auto vs. pedestrian/bicyclist at > 20 mph
• Motorcycle crash > 20 mph

Step 4 — Special considerations

Age (< 15 or > 55), anticoagulant use, pregnancy > 20 weeks, and burns with trauma all lower the threshold for trauma-center transport. When in doubt, upgrade — under-triage is more dangerous than over-triage.