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                  Trauma TRIAGE Decision Guidelines for EMS providers

 

GOAL:            

 

To pr               Goal: To provide a Trauma Decision Scheme to assist with identification of major trauma patients      

            and provide direction to EMS providers for transport to the most appropriate trauma facility.

 

           a copy of Triage Decision Scheme is attached.

 

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* At this point, all reference to Level III facilities in the triage decision scheme will include all designated Level III facilities as well as those facilities pending designation as Level III facilities.

 

References used:

1.      American College of Surgeons, Committee on Trauma, Recourse for Optimal Care of the Injured Patient: 1993. pp19-23.

2.      Review of Triage Plans for TSA “G”, TSA “U”, and TSA “B”

 

The Lower Rio Grande Valley Regional Advisory Council on Trauma

Triage Decision Scheme for EMS Providers in TSA “V”

 

Consider Air Medical Evacuation if patient assessment determines
that air medical evacuation criteria is met.
 

Text Box: Primary Assessment & Vital Signs

 

   Pediatric trauma score <11

·     Evidence of Shock w/heart rate                 Impaired Respirations for any reason

  >120 or <60 & <90 Systolic BP or                    Continued altered level/loss of consciousness

·     Respiratory  distress with rate <10 or        Systolic BP <60 (Birth to 1 yr)

     >35 or                                                                        BP <70 (1 to 6 y/o)

·     Revised Trauma Score <10                                        BP <80 (7 to 14 y/o)

Text Box: Adult with:                                          Pediatric (<15 y/o) with: · Glascow Coma Scale <12 or                           Pediatric trauma score <11 ·     Evidence of Shock w/heart rate                 Impaired Respirations for any reason   >120 or <60 & <90 Systolic BP or                    Continued altered level/loss of consciousness ·     Respiratory  distress with rate <10 or        Systolic BP <60 (Birth to 1 yr)      >35 or                                                                        BP <70 (1 to 6 y/o) ·     Revised Trauma Score <10                                        BP <80 (7 to 14 y/o)

 

 

 

 

 

 

 

 

 

 

Adults w/2nd degree >10% TBS

extremities proximal to elbow & knee                         Children w/2nd degree >10% TBS

·     Flail Chest                                                             All w/3rd degree >2% TBS

·     Two or more long bone fractures                        All inhalation injuries

·     Pelvic fractures                                                    2nd/rd degree burns to face, hands, feet, or genitalia

·     Limb paralysis                                                      All burns associated w/ other trauma

·     Amputation proximal to wrist or ankle                ·     Scalping or degloving injuries

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Death in same passenger compartment

·         Extrication time >20 minutes                             Fall >20 feet

·         Rollover                                                           Crash, initial speed >20 mph

·         Crash major auto deformity >20 inches              Auto-Pedestrian or auto-bike >5 mph

·         Crash, passenger compartment intrusion            Pedestrian thrown or run over

        >12 inches                                                    Impalement injuries

·         Motorcycle crash >20 mph or rider                   Complicated handlebar injuries separated from bike

 

 

 

Age <5 or >55 y/o

· Cardiac disease, respiratory distress, diabetes,    Pregnancy 2nd or 3rd trimester

  cirrhosis, morbid obesity                                         Immunosuppressed

Text Box: · Bleeding disorder or on anticoagulants               Age <5 or >55 y/o · Cardiac disease, respiratory distress, diabetes,    Pregnancy 2nd or 3rd trimester   cirrhosis, morbid obesity                                         Immunosuppressed