La. Admin. Code tit. 48 § I-19123
Assess for Extremis | ||
* Unmanageable airway * Tension pneumothorax * Traumatic cardiac arrest * Burn patient without patent airway * Burn patient > 40 percent BSA without IV or IO Access | Yes [RIGHT ARROW] | Closest ED/Trauma Center |
No [DOWN ARROW] | ||
Measure vital signs and Mental Status | ||
* Unable to follow commands (Motor GCS <6) * RR <10 or > 29 breaths per minute (<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. |
* Respiratory distress or need for support * Room air pulse oximetry <90% * Age 0-9: SBP <70 mmHG + (2 x age in years) * Age 10-64: SBP <90 mmHG or HR > SBP * Age [GREATER THAN EQUAL TO] 65: SBP <110 mmHG or HR SBP | * If distance or patient condition impedes transport to Level 1 or 2, consider transport to a Level 3 Trauma Center/Trauma Program or most appropriate resourced hospital. | |
No [DOWN ARROW] | ||
Assess Injury Patterns | ||
* All penetrating injuries to head, neck, torso, and extremities proximal to elbow or knee * Chest wall instability or deformity or suspected flail chest * Suspected fracture of two or more proximal long-bones * Crushed, de-gloved, mangled, or pulseless extremity * Amputation proximal to wrist or ankle * Suspected pelvic fracture * Skull deformity or suspected skull fracture * Suspected spinal injury with new motor or sensory loss * Active bleeding requiring a tourniquet or wound packing with continuous pressure | 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 I or a Level 2 Trauma Center or Trauma Program. * If distance or patient condition impedes transport to Level 1 or 2, consider transport to a Level 3 Trauma Center/Trauma Program or most appropriate resourced hospital |
No [DOWN ARROW] | ||
Assess mechanism of injury | ||
* Falls from height >10 feet (all ages) * High-risk auto crash -- Intrusion, including roof: - 12 inches occupant site; - 18 inches any site; -need for extrication for patient entrapped - Ejection (partial or complete) from automobile - Death in the same passenger compartment - Child (Age 0-9)unrestrained or in unsecured child safety seat - Vehicle telemetry data consistent with a high risk of injury * Auto vs. pedestrian/bicyclist thrown, run over, or with significant (20 mph) impact * Rider separated from transport vehicle with significant impact (ex: motorcycle, ATV, Horse, etc.) | 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. |
No [DOWN ARROW] | ||
Assess special patient or system considerations | ||
* Older Adults - Age [GREATER THAN EQUAL TO] 65 with evidence of traumatic injury - Fall from any height with evidence of significant head impact - Use of anticoagulant or antiplatelet drugs * Children - Age [LESS THAN EQUAL TO] 5 with evidence of traumatic injury - Fall from any height with evidence of significant head impact * Burns - In conjunction with trauma - High voltage electrical injuries * Pregnancy 20 weeks * Major joint dislocations (hip, knee, ankle, elbow) * 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 | Transport according to protocol |
La. Admin. Code tit. 48, § I-19123