USA Center for Rural Public Health Preparedness selected to lead national emergency response project

When emergency first responders across the country struggled to implement the latest national guidelines for field trauma triage, the USA Center for Rural Public Health Preparedness (USA Center), based at Texas A&M University, was asked to lead the effort to turn the situation around.

The USA Center is leading a major, four-year project with faculty, students and staff from Texas A&M’s College of Medicine, School of Public Health, and the Engineering Extension Service (TEEX) to identify and overcome the various obstacles so that the 2021 triage updates can be fully adopted.

The project was awarded through a cooperative effort between the National Highway Traffic Safety Administration and the National Center for Disaster Medicine and Public Health, which is administered under the Uniformed Services University, of which the Texas A&M School of Public Health was among the first cohorts.

“Triage—when first responders assess the severity of patient injuries to determine the need for treatment and what treatment to provide—is critical to saving lives at the scene of a car crash, fire or other emergency,” said Jason Moats, director of the USA Center and a faculty member with the Texas A&M School of Public Health. “The updated guidelines could benefit emergency responders and patients alike once the issues are addressed.”

Moats said the guidelines were written by the American College of Surgeons to help emergency medical service providers identify patients who have the highest risk of death from severe injuries. The 2021 guidelines updated previous versions and focus on simplifying decision-making processes for triage and determining the best care for patients in pre-hospital situations.

“A significant number of the nation’s 23,000 licensed emergency response agencies—especially those that are small or serve rural or other underserved populations—simply cannot provide the training or build in the policies needed because they lack the needed staffing, funding and other resources,” Moats said. “In addition, there were issues with the way the new guidelines were initially propagated, and as a result, the guidelines have not been adopted well or uniformly.”

The greatest challenge, Moats said, is that “one size does not fit all” when it comes to emergency management capabilities and capacities. “Our goal is to produce guidelines that are equally useful and relevant for anyone, whether they are in Alaska or Alabama.”

The project has three phases. The first, now underway, is the selection of emergency medical service providers that represent the range of provider types and populations they serve. Moats said providers from across the country, including those serving tribal nations and rural communities, have expressed interest in participating.

In the second phase, the USA Center team will provide funding, technical assistance and other resources so that select EMS agencies can deploy the guidelines. The team will then evaluate the deployment and develop tailored strategies for improved implementation that comparable EMS agencies around the country can use as a model. Finally, the team will develop a comprehensive guide to best practices for all such agencies.

“The best word for what we’re doing is ‘translation,’ meaning our ability to translate science into practice and practice into science,” Moats said. “The USA Center, our Texas A&M and TEEX colleagues have extensive expertise in the national policy domain as well as helping communities enhance their disaster resilience standing. Doing that for the nation’s emergency responders is what this is all about.”