Paramedic Kardex

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