La. Admin. Code tit. 48 § I-19117

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

Section I-19117 - LERN Destination Protocol: Trauma

A. On November 21, 2013, 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 26, 2012, and repealing "LERN ENTRY CRITERIA, Trauma Pre -Hospital and Hospital Triage Protocol" adopted and promulgated April 21, 2011, as follows.

1. Call LERN Communication Center at (866) 320-8293 for patients meeting the following criteria.

* Unmanageable airway	[RIGHTWARDS ARROW]	Closest ED/Trauma Center
* Tension pneumothorax
* Traumatic cardiac arrest
* Burn patient without patent airway
* Burn patient 40 percent BSA without IV
NO [DOWNWARDS ARROW]

Physiologic
* GCS < 14	[RIGHTWARDS ARROW]	To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center
* 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 & >=9 y/o)
< 15 or >30 (age 1 to 8 y/o)
< 25 or >50 (< 12 m/o)
NO [DOWNWARDS ARROW]
Anatomic
* Open or depressed skull fractures	[RIGHTWARDS ARROW]	To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center
* Open head injury with or without CSF leak
* Lateralizing signs or paralysis (i.e., onesided weakness, motor, or sensory deficit)
* All penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee
* Flail Chest
* 2 or more proximal long-bone fractures
* Crush, degloved or mangled extremity
* Amputation proximal to wrist and 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)
NO [DOWNWARDS ARROW]
Mechanism
* Falls >20 ft. adults	[RIGHTWARDS ARROW]	To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center
>10 ft. (child) or 2 to 3 times height
* 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
NO [DOWNWARDS ARROW]
Other
* Pregnancy >20 weeks	[RIGHTWARDS ARROW]	To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center
* 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]	To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center

B. This protocol was published at LR 40:190-191 (January 20, 2014).

La. Admin. Code tit. 48, § I-19117

Promulgated by the Department of Health and Hospitals, Louisiana Emergency Response Network, LR 41:145 (January 2015).

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