La. Admin. Code tit. 48 § I-19119
* Unmanageable airway | Yes [RIGHTWARDS ARROW] | Closest ED/ Trauma Center |
* Tension pneumothorax | ||
* Traumatic cardiac arrest | ||
* Burn patient without patent airway | ||
* Burn patient 40 percent BSA without IV | ||
[DOWNWARDS ARROW] No | ||
Measure vital signs and level of consciousness | ||
* GCS <=13 | Yes [RIGHTWARDS ARROW] | Transport to Trauma Center/ Trauma Program These patients should be transported to the highest level of care within the defined trauma system. This is a Level 1 or a Level 2 Trauma Center or Trauma Program. * If distance or patient condition impedes transport to trauma facility, consider transport to most appropriate resourced hospital |
* SBP <90mmHg | ||
* RR <10 or >29 breaths per minute, or need for ventilator Support (<20 in infant aged <1 year) | ||
[DOWNWARDS ARROW] No | ||
Assess anatomy of injury | ||
* All penetrating injuries to head, neck, torso, and extremities proximal to elbow or knee | Yes [RIGHTWARDS ARROW] | Transport to Trauma Center/ Trauma Program These patients should be transported to the highest level of care within the defined trauma system. This is a Level 1 or a Level 2 Trauma Center or Trauma Program. * If distance or patient condition impedes transport to trauma facility, consider transport to most appropriate resourced hospital |
* Chest wall instability or deformity (e.g. flail chest) | ||
* Two or more proximal long-bone fractures | ||
* Crushed, degloved, mangled, or pulseless extremity | ||
* Amputation proximal to wrist or ankle | ||
* Pelvic fractures | ||
* Open or depressed skull fracture | ||
* Paralysis | ||
* Fractures with neurovascular compromise (decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture) | ||
[DOWNWARDS ARROW] No | ||
Assess mechanism of injury and evidence of high -energy impact | Yes [RIGHTWARDS ARROW] | Transport to Trauma Center/Trauma Program which, depending upon the defined trauma system, need not be the highest level trauma center/program. If no Trauma Center/Trauma Program in the region, LCC may route to the most appropriate resourced hospital. |
* Falls | ||
- Adults: >20 feet (one story is equal to 10 feet) | ||
- Children: >10 feet or two or three times the height of the child | ||
* High-risk auto crash | ||
- Intrusion, including roof: | ||
>12 inches occupant site; | ||
>18 inches any site | ||
- Ejection (partial or complete) from automobile | ||
- Death in the same passenger compartment | ||
- Vehicle telemetry data consistent with a high risk of injury | ||
* Auto vs. pedestrian/bicyclist/ ATV thrown, run over, or with significant (20 mph) impact | ||
* Motorcycle crash 20mph | ||
[DOWNWARDS ARROW] No | ||
Assess special patient or system considerations | ||
* Older Adults | Yes [RIGHTWARDS ARROW] | Transport to Trauma Center/Trauma Program which, depending upon the defined trauma system, need not be the highest level trauma center/program. If no Trauma Center/Trauma Program in the region, LCC may route to the most appropriate resourced hospital. |
- Risk of injury/death increases after age 55 years | ||
- SBP <110 may represent shock after age 65 | ||
- Low impact mechanisms (e.g. ground level falls) may result in severe injury | ||
* Children | ||
- Should be triaged preferentially to pediatric capable trauma centers | ||
* Anticoagulants and bleeding disorders | ||
- Patients with head injury are at high risk for rapid deterioration | ||
* Burns | ||
- With trauma mechanism: triage to trauma center | ||
* Pregnancy 20 weeks | ||
* 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 | ||
* EMS provider judgment | ||
[DOWNWARDS ARROW] No | ||
Multi/Mass Casualty Incident | No | Transport according to protocol |
La. Admin. Code tit. 48, § I-19119