LA co. EMS Reference 506

Trauma Criteria (Definition)
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Terms in this set (33)
Trauma Criteria (Definition)
Requires immediate transport to a designated trauma center
Systolic BP of less than 90, or less than 70 in infants less than one year of age.
Trauma criteria
Respiratory rate greater than 29breaths/min (sustained), less than 10 br/min. Less than 20 br/min in infants younger than one year or require ventilatory support.
Trauma criteria
Cardiopulmonary arrest with penetrating torso trauma unless based upon the paramedic's thorough assessment is found apneic, pulseless, asystolic, and w/o pupillary reflexes upon EMS arrival at the scene.
Trauma criteria
All penetrating injuries to head, neck, torso, and extremities proximal to the elbow or knee
Trauma criteria
Blunt head injury associated with a suspected skull fracture, altered level of consciousness (GCS < 14), seizures, unequal pupils, or focal neurological deficits.
Trauma criteria
Injury to the spinal column associated with acute sensory or motor deficit.
Trauma criteria
Blunt injury to the chest with unstable chest wall (Flail chest)
Trauma criteria
Diffuse abdominal tenderness
Trauma criteria
Suspected pelvic fx (excluding isolated hip fx from a ground level fall)
Trauma criteria
Extremity with: 1. Neurological/vascular compromise and/or crushed, de-gloved, or mangled extremity. 2. Amputation proximal to the wrist or ankle. 3. Fractures of two or more proximal long bones (Femur/humerus) 4. Bleeding not controlled by direct pressure that requires the use of a tourniquet or hemostatic agent.Trauma criteriaFalls: 1. Adult pts from heights greater than 15 feet 2. Pediatric pts from heights greater than 10 feet or that 3 times the height of the child.Trauma criteriaPassenger space intrusion of greater than 12 inches into an occupied passenger space.Trauma criteriaEjected from vehicles (partial/complete)Trauma criteriaAuto vs Ped/bicyclist/motorcyclist thrown, run over, or with significant impact (20mph+).Trauma criteriaUnenclosed transport crash with significant impact (20mph+)Trauma criteriaMajor/Critical Burn (excluding those that are recognized burn centers): 1. Patients 15 y/o or older with 2nd degree burns and 3rd deg. equal to or greater than 20% of total body surface area. 2. Patients less than or equal to 14 y/o with 2nd and 3rd deg burns involving equal to or greater than 10% TBSATrauma criteriaTrauma Guidelines (Definition)MOI and pt history are the most effective methods of selecting critically injured patients before unstable vital signs develop. Paramedics and Base hospital personnel should consider MOI and pt Hx to determine patient destination. Base discretion is used to determine transportation to a trauma center.Passenger space intrusion greater than 18 inches into any unoccupied passenger space.Trauma GuidelinesAuto vs Ped, Bicyclist, motorcycle with an impact less than 20mphTrauma GuidelinesInjured victims of vehicular crashes in which a fatality occurred in the same vehicleTrauma GuidelinesPatients requiring extricationTrauma GuidelinesVehicle telemetry data consistent with high risk of injuryTrauma GuidelinesInjured patients (excluding isolated minor extremity injuries): 1. on anticoagulation/antiplatelet therapy, or any other aspirin. 2. with bleeding disordersTrauma GuidelinesSpecial Considerations (Definition)Consider transporting injured patients to the trauma centerPatients in blunt traumatic full arrest who, based on a paramedic' thorough assessment, was not found apneic, pulseless, and without organized ECG activity (narrow complex SV rhythm) upon arrival of EMS.Special ConsiderationsAdults greater than 55 y/oSpecial ConsiderationsSystolic BP less than 110 may represent shock in those after the age of 65 y/o.Special ConsiderationsPregnancy greater than 20 weeks gestationSpecial ConsiderationsPrehospital judgementSpecial ConsiderationsExtremis Patients (definition)Requires immediate transport to the MARPTs with an obstructed airway or those with concern for imminent airway obstruction due to inhalation injuryExtremis PatientsPTs, as determined by the base hospital personnel, whose lives would be jeopardized by transportation to any destination but the MARExtremis Patients