La. Admin. Code tit. 48 § I-19115

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

Section I-19115 - LERN Destination Protocol: TRAUMA

A. On April 26, 2012, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and (3)] adopted and promulgated "LERN Destination Protocol: Trauma" replacing the "LERN Destination Protocol: Trauma" adopted and promulgated April 21, 2011, as follows.

* Unmanageable Airway	[RIGHTWARDS ARROW]	Closest ED
* Tension Pneumothorax
* Traumatic cardiac arrest
* Burn Patient without patent airway
* Burn patient >40 percent BSA without IV
Physiologic
* GCS <14	[RIGHTWARDS ARROW]	Level I, II, or III*
* SBP <90 (adults and >9 y/o)
<70 + 2 [age (yrs)] (age 1 to 8 y/o)
<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 y/o)
<25 or >50 (<12 m/o)
Anatomic
* Open or depressed skull fractures	[RIGHTWARDS ARROW]	Level I, II, or III*
* Open head injury with or without CSF leak
* Lateralizing signs or paralysis (i.e., one -sided weakness, motor, or sensory deficit)
* All penetrating injuries to head, neck, torso, & extremities proximal to elbow & knee
* Flail Chest
* 2 or more proximal long-bone fractures
* Crush, degloved or mangled extremity
* Amputation proximal to wrist & ankle
* Pelvic Fractures
* 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)
Mechanism
* Falls >20 ft. adults >10 ft. (child) or 2 to 3 times height	[RIGHTWARDS ARROW]	Level I, 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
Other
* Pregnancy >20 weeks	[RIGHTWARDS ARROW]	Level II, or III*
* Burns (follow ABA guidelines)
* Age >=55 y/o or <8 y/o
* Anticoagulation and bleeding disorders -patients w/ head injuries are at high risk for rapid deterioration
MULTI/MASS CASUALTY INCIDENT (MCI)	[RIGHTWARDS ARROW]	Level I, II, or III*

*Refers to ACS Verified Level Trauma Center Where trauma center not available, patient will be routed to facility with appropriate resource which may not need be the highest level facility.

B. This protocol was published at LR 38:1462-1463 (June 20, 2012).

La. Admin. Code tit. 48, § I-19115

Promulgated by the Department of Health and Hospitals, Emergency Response Network, LR 41:144 (January 2015).

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