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