Evaluation of the New South Wales Ambulance T1 Major Trauma transport protocol: a state-wide data linkage study

•Ambulance triage and transport protocols are critical components of the trauma system response to major injury.•The sensitivity of the New South Wales ambulance service was found to be 14% with a specificity of 90%. Undertriage and overtriage rates were 3% and 63% respectively.•The T1 protocol could be improved using a combination of clinical factors and other trauma treatment protocols.