A standardized set of physiologic, anatomic, and mechanistic indicators used to identify patients who require care at a designated trauma center. Positive TTC is determined by qualifying criteria documented in eInjury.03 or eInjury.04 per NEMSIS v3.5. Classification follows the step-down hierarchy defined in Policy PD# xxxx, which is editable per LEMSA in trauma_config.py.

The highest-priority classification, captured in eInjury.03. Physiologic criteria include abnormal vital signs, altered mental status, respiratory distress, or shock. Anatomic criteria include penetrating trauma to head/neck/torso, suspected pelvic fracture, flail chest, spinal injury with neurologic deficit, or amputation proximal to wrist/ankle. Any positive eInjury.03 value classifies the patient as positive TTC regardless of mechanism.

Applied when eInjury.03 is negative but eInjury.04 contains a qualifying high-energy mechanism — falls beyond the policy threshold, high-risk auto crash with significant intrusion, ejection, pedestrian struck at speed, or motorcycle crash above the policy threshold. Mechanistic criteria alone are sufficient to classify a patient as positive TTC per Policy PD# xxxx.

Notification from the transporting unit to the receiving trauma center prior to arrival, documented in eDisposition.24. Pre-alerts let the facility activate the trauma team before the patient arrives. Pre-alert rate is the percentage of positive-TTC patients for whom an alert was documented in ANY eDisposition.24 field — including multiple/recurring alert columns.

A patient who meets positive TTC criteria but has no trauma pre-alert documented in any eDisposition.24 field. Missed alerts are a primary QI focus and are individually listed in the Flagged Incidents report, attributed to the transporting agency.

A trauma pre-alert documented in eDisposition.24 where the patient did not meet positive TTC criteria. Over-alerting can cause unnecessary resource activation, though clinical judgment may justify it. Flagged for review but not held to the same standard as missed alerts.

A pre-alert documented with a non-trauma activation type (e.g. Yes-STEMI or Yes-Stroke) on a trauma patient. The alert still counts toward the rate, but the mismatch is flagged so the provider can correct the documentation. Each program (Trauma, STEMI, Stroke, Sepsis, Cardiac Arrest) flags activation types that are not its own.

Cases where eInjury.04 contains only provider judgment, anticoagulant/bleeding-disorder history, pregnancy, burns, or suspicion of child abuse — without a qualifying mechanistic criterion. Per Policy PD# xxxx these may warrant trauma-center transport at paramedic discretion but do not meet positive TTC. Tracked separately; excluded from pre-alert and destination calculations.

The percentage of positive-TTC patients transported to a designated trauma center (eDisposition.02). Designation is resolved from the facilities file's designation tags, with a per-LEMSA fallback code list. Null or unrecognized destination codes count as non-compliant and are flagged for data-quality review. Target is 95% or greater.