Paramedic Kardex

The is a quick reference ONLY to the Policies and Guidelines set by OCEMSA.
All specific Treatment Guidelines questions should be directed to the OCEMSA Website.
Trauma criteria
Base Hospital Contact for all patients who meet trauma triage criteria
* Age limits are not absolute. Some rescuer judgment is allowed if patient meets all other criteria and rescuer is comfortable with patient responses and patient assessment.
Trauma Victim: - Blunt or penetrating injury with the presence of ANY of the following:
Abnormal Vital Signs:
- GCS: less than 14 (in presence of head injury), OR
- Resp: < 12 or > 30 (adults/adolescents/children), OR
- Systolic BP: < 90 (adults/adolescents); < 80 (children 14 y/o and under)
Injuries:
- Penetrating or open injury of the head, depressed skull fx
- Blunt head injury with loss of consciousness greater than 5 minutes
- Penetrating injury to neck, chest, abdomen, back or groin
- Penetrating injury to extremity above elbow or knee
- Extremity w/ poor circulation or w/o pulse
- Paralysis or numbness of arm or leg (suspicion of spinal cord injury)
- Flail chest
- Seat belt bruising or abrasion of neck, chest or abdomen
- Unstable pelvic fractures
- Abdominal injury, blunt, w/ tenderness of 2 or more quads
- Fx of 2 or more long-bones (femur/humerus)
- Pelvic pain or deformity on palp (+ barrel hoop)
- Amputation above wrist or ankle
- Crushed / de-gloved, or mangled extremity (excluding only fingers/toes)
Mechanism of Injury:
Falls:
- Adults/Adolescents: > 15 ft. (one story is equal to 10 ft.), and fall from galloping horse
- Children > 10 ft. or 2-3 times height of child, and fall from galloping horse
High-Risk Auto Crash:
- Passenger space intrusion > 12 inches occupant site; > 18 inches any site w/in passenger space
- Ejection (partial or complete) from auto
- Death in same passenger compartment
- Dive and shore break injuries with suspected spinal cord injury
- Auto vs. pedestrian/bicyclist thrown any distance, run-over, or with significant (> 20 mph) impact
- Motorcycle crash including “laying bike down”, > 20 mph
TFA:
- Unmanageable Airway – Closest PTRC (Unless on Diversion)
- Blunt or Penetrating Trauma (including pregnant) - PTRC
- Pregnant traumatic full arrest goes to PTRC
Special Situations:
Patients with significant injury and any of the following may benefit from specialized trauma services; contact the Base Hospital for destination decision regarding those with injury and: BHC
- Age 75 years-old or greater
- Burns or Victims of Explosions
- Anticoagulation and bleeding disorders (Coumadin, Plavix, Levenox, Abciximab, Apixaban, Clopidogrel, Diabigatran, Effient, Eliquis, Pradaxa, ReoPro, Rivaroxaban, Xarelto, or "Blood thinners")
- End-Stage Renal Disease on dialysis
- Pregnancy > 20 weeks
- EMS provider judgment that transport to a PTRC will benefit injured victim