La. Admin. Code tit. 48 § I-19121
* Unmanageable airway * Tension pneumothorax * Traumatic cardiac arrest * Burn patient without patent airway * Burn patient > 40 percent BSA without IV | Yes [RIGHT ARROW] | Closest ED/Trauma Center |
No [DOWN ARROW] | ||
Measure vital signs and level of consciousness | ||
* GCS <=13 * SBP <90mmHg * RR <10 or >29 breaths per minute, or need for ventilator Support (<20 in infant aged <1 year) | Yes [RIGHT 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. |
No [DOWN ARROW] | ||
Assess anatomy of injury | ||
* All penetrating injuries to head, neck, torso, and extremities proximal to elbow or knee * 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) | Yes [RIGHT 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. |
No [DOWN ARROW] | ||
Assess mechanism of injury and evidence of high-energy impact | ||
* 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; | Yes [RIGHT 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. |
> 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/AT V thrown, run over, or with significant (>20 mph) impact *Motorcycle crash >20mph | ||
No [DOWN ARROW] | ||
Assess special patient or system considerations | ||
*Older Adults -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 | Yes [RIGHT ARROW] | Transport to Trauma Center/Trauma Program or hospital capable of timely and thorough evaluation and initial management of potentially serious injuries. Consider consultation with medical control. |
No [DOWN ARROW] | ||
Multi/Mass Casualty Incident | No [RIGHT ARROW] | Transport according to protocol |
La. Admin. Code tit. 48, § I-19121