La. Admin. Code tit. 48 § I-19103

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-19103 - Region 7 LERN Entry and Destination Protocols

A. On November 15, 2007, the Louisiana Emergency Response Network Board [R.S. 40:2842(1)] adopted and promulgated "Region 7 LERN Entry and Destination Protocol" for region 7 of the Louisiana Emergency Response Network [R.S. 40:2842(3)], which region includes the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto, Natchitoches, Red River, Sabine and Webster, as follows.

a. Traumatic patients who meet the following criteria will be entered to LERN call center and should be transported directly to LSUHSC in Shreveport, Louisiana, if possible:

i. airway compromise (intubated, apneic, or obstructed airway);

ii. penetrating wound of head, neck, chest, abdomen, groin, or buttocks;

iii. blood pressure <=100 or signs of shock;

iv. GCS 12 or less;

v. new onset neurological deficit associated with traumatic event;

vi. extremity wound with absent pulse or amputation proximal to foot or hand.

b. Trauma patients who meet the following criteria, and are located outside the city limits of Shreveport and Bossier City, should be taken to nearest hospital for immediate stabilization followed by continued rapid transport to LSUHSC Shreveport per the LERN hospital protocol:

i. unable to establish and maintain adequate airway/ventilation;

ii. hypotension unresponsive to crystalloids (no more than 2 L);

iii. patients who meet trauma center criteria but have a transport time 60 minutes;

iv. traumatic arrest.

B. On May 8, 2008, the Louisiana Emergency Response Network Board (R.S. 40:2842(1)) amended and promulgated, as amended, "Region 7 LERN Entry and Destination Protocol" for region 7 of the Louisiana Emergency Response Network (R.S. 40:2842(3)), which region includes the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto, Natchitoches, Red River, Sabine and Webster, which protocol was originally adopted and promulgated on November 15, 2007, so that the "Region 7 Louisiana Emergency Response Network Entry and Destination Protocol," as amended, effective May 8, 2008, is as follows.

a. Traumatic patients who meet the following criteria will be entered to LERN call center and should be transported directly to LSUHSC in Shreveport, if possible:

i. airway compromise (intubated, apneic, or obstructed airway);

ii. penetrating wound of head, neck, chest, abdomen, groin, or buttocks;

iii. blood pressure <=100 or signs of shock;

iv. GCS 12 or less;

v. new onset neurological deficit associated with traumatic event;

vi. extremity wound with absent pulse or amputation proximal to foot or hand;

vii. burn patients as identified following ABA guidelines;

viii.healthcare provider discretion-patients evaluated by hospitals may be entered into LERN if the evaluating hospitals medical personnel determines the patient has a medical condition requiring immediate surgical evaluation and/or intervention and the transferring hospital does not have these services immediately available at that facility (Healthcare provider discretion does not include orthopedic injuries.).

b. Patients that have been entered into LERN but will require greater than 60 minute transport time from the field should stop at local area hospitals for stabilization. These patients should still be entered into LERN from the field but will require transport to local area hospitals for stabilization. LERN will facilitate the movement of these patients from the local hospital once stabilizing measures are completed.

i. The following are conditions requiring immediate stabilization by local area hospitals:

(a). unable to establish and maintain adequate airway/ventilation;

(b). hypotension unresponsive to crystalloids (no more than 2 L);

(c). patients who meet trauma center criteria but have a transport time >60 minutes;

(d). traumatic arrest.

C. The following will be routed directly to the LSUHSC Burn Unit from local area hospitals or from the field:

1. partial-thickness and full thickness burns greater than 10 percent of the total body surface area (TBSA) in patients younger than 10 years of age or older than 50 years of age;

2. partial-thickness and full thickness burns greater than 20 percent of the total body surface area (TBSA) in other age groups;

3. partial-thickness and full thickness burns involving the face, eyes, ears, hands, feet, genitalia, perineum, or skin overlying major joints;

4. full-thickness burns greater than 5 percent TBSA in any age group;

5. electrical burns, including lightning injury;

6. chemical burns;

7. patients with inhalation injury;

8. burn injury in patients with pre-existing illnesses that could complicate management, prolong recovery, or adversely affect mortality risk;

9. any burn patient in whom concomitant trauma poses an increased risk of morbidity or mortality may be treated initially in a trauma center until stable before transfer to a burn center;

10. children with burns seen in hospitals without qualified personnel or equipment for their care;

11. burn injury in patients who will require special social and emotional or long-term rehabilitative support, including cases involving suspected child abuse or neglect.

D. These protocols were published at LR 35:1183-1184 (June 20, 2009).

La. Admin. Code tit. 48, § I-19103

Promulgated by the Department of Health and Hospitals, Emergency Response Network, LR 41:139 (January 2015).

AUTHORITY NOTE: Promulgated in accordance with R.S. 9:2798.5 and R.S. 40:2846(A).