Month 7; National Trauma Triage Protocol

Question 0

Step 2

Anatomy of Injury

Answer 0

• All penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee.
• Flail Chest
• Two or more proximal long-bone fractures
• Crushed, Degloved, or Mangled Extremity
• Amputation proximal to wrist and ankle
• Pelvic Fractures
• Open or depressed skull fractures
• Paralysis

(Yes) —> Take to Trauma Center

Question 1

Step 1

Vital Signs and Level on Consciousness

Answer 1

• Glasgow Coma Scale less than 14
• Systolic Blood Pressure less than 90
• Respiratory Rate less than 10 or greater than 29
  
  • Infant less than 20

(Yes) —-> Take to Trauma Center

Question 2

Step 3

Mechanism of Injury and evidence of High Energy Impact

Answer 2

Falls

• Adult, greater than 20 ft.
• Children, greater than 10 ft, or 2 to 3x their height.

High Risk Auto Crash

• Intrusion greater than 12 inches on occupant site.
• Intrusion greater than 18 inches on any site
• Death of another occupant
• Ejection (Partial or Complete)
• Vehicle Telemetry Data consistent with high risk of injury

Auto vs. Pedestrian
- Over 20 mph

Motorcycle Crash
- Over 20 mph

(YES) —> Transport to trauma center

Question 3

Step 4

Special Patient or System Considerations

Answer 3

• Age
  
  • Older Adults greater than 55 at greater risk
  • Children

-Anticoagulation and Bleeding Disorders

• Burns
  
  • Without other trauma mechanism: Triage to burn facility
  • With trauma mechanism: Triage to Trauma Center
• Time Sensitive Extremity Injury
• End Stage Renal Failure, Requiring Dialysis
• Pregnancy Greater than 20 Wks
• EMS Judgment

(YES) —> Contact medical control and consider transport to a trauma center or a specific resource hospital.