La. Admin. Code tit. 48 § I-19101

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-19101 - Entry Criteria and Region 4 LERN LCC Destination Protocol

A. On November 15, 2007, the Louisiana Emergency Response Network Board [R.S. 40:2842(1)] adopted and promulgated "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol" for region 4 of the Louisiana Emergency Response Network (R.S. 40:2842(3)), which region includes the parishes of Acadia, Evangeline, Iberia, Lafayette, St. Martin, St. Landry, and Vermilion, as follows.

1. LERN Entry Criteria

LERN Entry Criteria
[] Unmanageable Airway	YES [RIGHTWARDS ARROW]	Call LCC
[] Tension Pneumothorax
[] Traumatic cardiac arrest
[] Burn patient without patent airway
[] Burn patient >40% 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)
[] 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:
>20 in. any site
[] Ejection, partial or complete from automobile
[] Death in same passenger compartment
[] Auto vs. pedestrian/bicyclist thrown, run
over or >5 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

2. LERN Region 4 LCC Destination Protocol

LERN Region 4 LCC Destination Protocol
[] Unmanageable Airway [] Tension Pneumothorax [] Traumatic cardiac arrest [] Burn p atient without patent airway [] Burn patient 40 percent BSA without IV	YES [RIGHTWARDS ARROW]	Closest ED
NO [DOWNWARDS ARROW]
Neurologic Trauma
[] GCS <14 + one or more of the following: [] 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., onesided weakness, motor, or sensory deficit)	YES [RIGHTWARDS ARROW]	LERN Level II
NO [DOWNWARDS ARROW]

LERN Region 4 LCC Destination Protocol
Physiologic
[] SBP <90 (adults and >9 y/o)	YES [RIGHTWARDS ARROW]	LERN Level 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 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)
[] 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.)
[DOWNWARDS ARROW]
Mechanism
[] Falls >20 ft. (adults)	YES [RIGHTWARDS ARROW]	LERN Level II or III
>10 ft. (child) or 2 to 3 times height
[] High-risk auto crash
[] Intrusion >12 in. occupant site:
>20 in. any site
[] Ejection, partial or complete from automobile
[] Death in same passenger compartment
[] Auto vs. pedestrian/bicyclist thrown, run over or >5 MPH impact
[] Motorcycle crash 20 MPH
NO [DOWNWARDS ARROW]
Special
[] Pregnancy 20 weeks [] Burns (will follow ABA guidelines)	YES [RIGHTWARDS ARROW]	LERN
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

B. On June 26, 2008, the Louisiana Emergency Response Network Board passed a resolution allowing any region of the Louisiana Emergency Response Network which agreed to use the foregoing "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol" to begin operating using the "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol" set forth above.

C. This protocol was published at LR 35:1181-1183 (June 20, 2009).

La. Admin. Code tit. 48, § I-19101

Promulgated by the Department of Health and Hospitals, Emergency Response Network, LR 41:138 (January 2015).

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