OCEMS Trauma Triage

Trauma Triage - Base Hospital Order

Any patient meeting trauma triage criteria requires BH contact

Trauma Triage Criteria - Injuries (Extremities)

Extremity injuries: - Penetrating (appears to penetrate all skin layers) injury to extremity above elbow or knee - Extremity injury w/ poor circulation or w/o a pulse - Paralysis or paraesthesia of arm or leg due to injury - Fracture of 2 or more long bones (humerus, femur) - Amputation (partial or complete) above wrist or ankle - Crushed, degloved, or mangled extremity (excluding only fingers or toes)

Trauma Triage Criteria - MOI

Falls: - Adult/Adolescent: >15 ft (one story is 10 ft) - Child: >10 ft or 2-3x height of child - Adult/Adolescent: Fall from a galloping horse High Risk Auto Crash: - Passenger space intrusion > 12 inches where occupant (who would be defined as a trauma victim) is sitting or any occupant in a passenger seat w/ >18 inches intrusion at any site w/in passenger space. - Ejection (partial or complete) from automobile - Passenger who is in the same compartment in which a trauma death occurred - Dive and shore break injury with suspected spinal cord injury - Hanging - Auto vs Ped/Cyclist who is thrown any distance, run over, or w/ a significant (>20mph) impact - Unenclosed MVC (motorcycle, bike, scooter, etc.) >20 mph, including "laying bike down"

Trauma Triage Criteria - Injuries (Head)

Head Injuries: - Depressed skull fracture - Penetrating or open head injury - Blunt or penetrating head trauma with observed LOC, focal neurologic deficit, asymmetrical pupils, or vomiting - Blunt head injury with bruising in the area of injury and known to be taking anticoagulants or platelet inhibitors (blood thinners) excluding aspirin - Known to have hemophilia - Known dialysis patient

Trauma Triage - EMS Provider Judgement

If EMS provider judgement at scene believes injury victim will benefit from Trauma Center Transport, contact BH for destination

Trauma Triage Criteria - Injuries (Neck/Chest/Abdomen/Back/Pelvis/Groin Injuries)

Neck/Chest/Abdomen/Back/Pelvis/Groin Injuries: - Penetrating (appears to penetrate all skin layers) injury to neck, chest, abdomen, back, or groin - Blunt chest injury w/ abnormal respirations - Seat belt bruising or abrasion of neck, chest, or abdomen - Blunt abdominal injury w/ palpable tenderness - Pelvic rim pain or deformity on palpation - Reported or obviously pregnant woman w/ blunt or penetrating abdominal injury

Trauma Triage Criteria - Abnormal Vital Signs

Person sustaining blunt or penetrating trauma with any of the following: - Failure to follow commands due to acute decrease in usual mental status - Respirations for adults/adolescents/and children: < 12 or > 30 - Systolic BP: Adults/Adolescents - < 90 Children - < 80

Trauma Triage - Traumatic Respiratory & Cardiopulmonary Arrest

Trauma pts presenting w/ following should be transported to Trauma Center (BH physician discretion) - Unmanageable airway - Traumatic cardiopulmonary arrest