The Mechanisms of Injury used to triage patients to trauma centers are inefficient (10.6% accurate overall) to identify Major Trauma Patients, not already identified by reduced physiologic status or the presence of an anatomic factor. The Positive Predictive Value for each Mechanism of Injury associated with motor vehicle crashes was calculated using a 17,735 patient trauma registry. Those Mechanisms dealing with vehicle deformation were found to be particularly inefficient in the identification of a major trauma patient. Comparison with the Triage Guidelines of the Committee on Trauma of the American College of Surgeons found the basic staging of criteria to be correct. Some modifications to these criteria are discussed. Recommendations are made for an expanded collection of data which links detailed vehicle crash analysis with the extensive clinical findings of an inpatient medical record as summarized in a trauma registry.