La. Admin. Code tit. 48 § I-19109
Standard LERN Entry Criteria | ||
Pre-Hospital and Hospital Triage Protocol | ||
[] Unmanageable Airway | YES [RIGHTWARDS ARROW] | Call LCC |
[] Tension Pneumothorax | ||
[] Traumatic cardiac arrest | ||
[] Burn patient without patent airway | ||
[] Burn patient >40 percent BSA without IV | ||
Neurologic Trauma | ||
[] GCS <14 + one or more of the following: | YES [RIGHTWARDS ARROW] | Call LCC |
[] Penetrating head injury or depressed skull fracture | ||
[] Open head injury with or without CSF leak | ||
[] Deterioration of the GCS | ||
[] Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit) | ||
Physiologic | ||
[] SBP <90 (adults and >9 y/o) | YES [RIGHTWARDS ARROW] | Call LCC |
<70 + 2 [age (yrs)] (age 1 to 8) | ||
<70 (age 1 to 12 months) | ||
<60 (term neonate) | ||
[] RR <10 or >29 (adults and=9 y/o) | ||
<15 or >30 (age 1 to 8) | ||
<25 or >50 (<12 m/o) | ||
Anatomic | ||
[] All penetrating injuries to neck, torso and extremities proximal to elbow and knee | YES [RIGHTWARDS ARROW] | Call LCC |
[] Flail Chest | ||
[] 2 or more proximal long-bone fractures | ||
[] Crush, degloved or mangled extremity | ||
[] Amputation proximal to wrist and ankle | ||
[] Pelvic Fracture | ||
[] Hip fractures (hip tenderness, deformity, lateral deviation of foot) excluding isolated hip fractures from same level falls | ||
[] Major joint dislocations (hip, knee, ankle,elbow) | ||
[] Open Fractures | ||
[] Fractures with neurovascular compromise | ||
(decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture, etc.) | ||
Mechanism | ||
[] Falls >20 ft. (adults) | YES [RIGHTWARDS ARROW] | Call LCC |
>10 ft. (child) or 2 to 3 times height | ||
[] High -risk auto crash | ||
Intrusion >12 in. occupant site: | ||
>18 in. any site | ||
* Ejection, partial or complete from automobile | ||
* Death in same passenger compartment | ||
[] Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 MPH) impact | ||
[] Motorcycle crash >20 MPH | ||
Special | ||
[] Pregnancy >20 weeks | YES [RIGHTWARDS ARROW] | Call LCC |
[] Burns (will follow ABA guidelines) | ||
Other | ||
[] Age >=55 y/o or <8 y/o | YES [RIGHTWARDS ARROW] | Call LCC |
[] Anticoagulation and bleeding disorders | ||
[] End stage renal disease | ||
[] Transplant patients | ||
Standard Destination Protocol | ||
[] Unmanageable Airway | YES [RIGHTWARDS ARROW] | Closest ED |
[] Tension Pneumothorax | ||
[] Traumatic cardiac arrest | ||
[] Burn patient without patent airway | ||
[] Burn patient >40 percent BSA without IV | ||
NO [DOWNWARDS ARROW] | ||
Neurologic Trauma | ||
[] GCS <14 | YES [RIGHTWARDS ARROW] | LERN Level I or II |
[] Penetrating head injury or depressed skull fracture | ||
[] Open head injury with or without CSF leak | ||
[] Deterioration of the GCS | ||
[] Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit) | ||
NO [DOWNWARDS ARROW] | ||
Physiologic | ||
[] SBP <90 (adults and >9 y/o) | YES [RIGHTWARDS ARROW] | LERN Level I, II or III |
<70 + 2 [age (yrs)] (age 1 to 8) | ||
<70 (age 1 to 12 months) | ||
<60 (term neonate) | ||
[] RR <10 or >29 (adults and=9 y/o) | ||
<15 or >30 (age 1 to 8) | ||
<25 or >50 (<12 m/o) | ||
NO [DOWNWARDS ARROW] | ||
Anatomic | ||
[] All penetrating injuries to neck, torso and extremities proximal to elbow and knee | YES [RIGHTWARDS ARROW] | LERN Level I, II or III |
[] Flail Chest | ||
[] 2 or more proximal long-bone fractures | ||
[] Crush, degloved or mangled extremity | ||
[] Amputation proximal to wrist and ankle | ||
[] Pelvic Fracture | ||
[] Hip fractures (hip tenderness, deformity, lateral deviation of foot) excluding isolated hip fractures from same level falls | ||
[] Major joint dislocatio ns (hip, knee, ankle, elbow) | ||
[] Open Fractures | ||
[] Fractures with neurovascular compromise (decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture, etc.) | ||
Standard Destination Protocol | ||
NO [DOWNWARDS ARROW] | ||
Mechanism | ||
[] Falls >20 ft. (adults) >10 ft. (child) or 2 to 3 times height | YES [RIGHTWARDS ARROW] | LERN Level II or III |
[] High-risk auto crash | ||
* Intrusion >12 in. occupant site: | ||
* >18 in. any site | ||
* Ejection, partial or complete from automobile | ||
* Death in same passenger compartment | ||
[] Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 MPH) impact | ||
[] Motorcycle crash >20 MPH | ||
NO [DOWNWARDS ARROW] | ||
Special | ||
[] Pregnancy 20 weeks | YES [RIGHTWARDS ARROW] | LERN Level II or III |
[] Burns (will follow ABA guidelines) | ||
NO [DOWNWARDS ARROW] | ||
Other | ||
[] Age >=55 y/o or <8 y/o | YES [RIGHTWARDS ARROW] | LERN Level II, III or IV |
[] Anticoagulation and bleeding disorders | ||
[] End stage renal disease | ||
[] Transplant patients | ||
La. Admin. Code tit. 48, § I-19109