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Comment & Response
November 2017

Undertriage of Firearm-Related Injuries Not Actually Assessed

Author Affiliations
  • 1Chicago West EMS System, Cook County Health and Hospitals System, Chicago, Illinois
  • 2Department of Emergency Medicine, Stroger Cook County Hospital, Chicago, Illinois
  • 3Department of Emergency Medicine, Rush Medical College, Chicago, Illinois
JAMA Surg. 2017;152(11):1091. doi:10.1001/jamasurg.2017.2352

To the Editor I read with great interest the recent publication “Undertriage of Firearm-Related Injuries in a Major Metropolitan Area” by Lale et al.1 The US Centers for Disease Control and Prevention/American College of Surgeons Guidelines for Field Triage of Injured Patients is the nationally recognized standard used by emergency medical services (EMS) paramedics and basic emergency medical technicians to determine whether trauma patients should be transported to a trauma vs nontrauma center.2 These guidelines define undertriage as “inaccurate triage that results in a patient who requires higher-level care not being transported to a Level 1 or Level 2 trauma center.”3 Thus, to define a case as undertriage, knowledge of the EMS triage and transport decision must be present.