Each year, the approximately 1 million emergency medical services (EMS) providers have a substantial impact on the care of injured persons and on public health in the United States.
[1] In 1976, American College of Surgeons (ACS) ACS-COT began publishing resource documents to provide guidance for designation of facilities as trauma centers and appropriate care of acutely injured patients.
The Panel brought representatives with additional expertise to the revision process (e.g., persons in EMS, emergency medicine, public health, the automotive industry, and other federal agencies).
The initial 1976 guidance by ACS-COT contained no specific triage criteria but did include physiologic and anatomic measures that allowed stratification of patients by injury severity.
[2] Also in 1976, ACS-COT developed guidelines for the verification of trauma centers, including standards for personnel, facility, and processes deemed necessary for the optimal care of injured persons.
For example, the Decision Scheme may be modified to a specific environment (densely urban or extremely rural), to resources available (presence or absence of a specialized pediatric trauma center), or at the discretion of the local EMS medical director.