Trauma Triage

Algorithm

New UPDATED 4/1/2019

Abnormal Vital Signs:

- Failure to follow commands due to decreased state of alertness OR

- Resp: < 12 or > 30 (adults/adolescents/children), OR

- Systolic BP: < 90 (adults/adolescents); < 80 (children 14 y/o and under)

BHC → Meets Trauma Criteria → Trauma Center

 

Injuries:

Head Injuries

- Penetrating or open injury of the head,

- Depressed skull fracture

- Blunt or penetrating head injury with:

  • Loss of consciousness, OR

  • Focal neurologic deficit, OR

  • Asymmetric pupils, OR 

  • Vomiting

- Blunt head injury with bruising in area of injury and known to be:

  • Taking anticoagulants or platelet inhibitors ("blood thinners"), excluding ASA OR

  • Known to have hemophilia OR

  • Known to be a dialysis patient

 

Neck Injuries

- Penetrating (appears for penetrate all skin layers) injury to the neck

- Seat belt bruising or abrasion of neck

Chest / Back Injuries

- Penetrating (appears for penetrate all skin layers) injury to the chest or back

- Seat belt bruising or abrasion of chest

- Blunt chest injury with abnormal respiration as defined above

Abdominal / Pelvic Injuries

- Penetrating (appears for penetrate all skin layers) injury to the abdomen or groin

- Seat belt bruising or abrasion of abdomen

- Reported or obviously pregnant women with blunt or penetrating abdominal injury

- Blunt abdominal injury, w/ palpable tenderness

- Unstable pelvic fractures

- Pelvic rim pain or deformity on palp (+ barrel hoop)

Extremity Injuries

- Penetrating (appears for penetrate all skin layers) injury to extremity above elbow or knee

- Extremity injury w/ poor circulation or w/o pulse

- Paralysis or paresthesia of arm or leg due to injury

- Fracture of 2 or more long-bones (femur/humerus)

- Amputation (partial or complete) above  the wrist or ankle

- Crushed / de-gloved, or mangled extremity (excluding only fingers/toes)

BHC → Meets Trauma Criteria → Trauma Center

 

Mechanism of Injury:

Falls:

- Adults / Adolescents: > 15 ft. (one story is equal to 10 ft.)

- Children: > 10 ft. or 2-3 times height of child

- Adults / Adolescents / Children: fall from galloping horse

BHC → Meets Trauma Criteria → Trauma Center

 

High-Risk Auto Crash:

(heights, speeds, and distances are all estimates)

- 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

BHC → Meets Trauma Criteria → Trauma Center

 

Traumatic Full Arrests:

- Unmanageable Airway – Triage to a Trauma Center

- Traumatic Cardiopulmonary arrest - Triage to a Trauma Center

Call

M: 949-769-1162

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