50 - Adult - Trauma Assessment

Question 1

What are the criteria for a level 1 trauma?

Answer 1

Physiologic

• SBP under 90 in adults, taken 5 minutes apart
• SBP under 80 in pediatrics, taken 5 minutes apart
• GCS under 10
• Respirations under 10 or over 29

Anatomic

• Flail chest
• amputation proximal to wrist/ankle
• arm/leg paralysis or sensory deficit due to possible spinal injury
• suspected pelvic fracture with hypoTN
• 2+ long bone (humerus/femur) fractures
• 2+ body regions involved with potential life/limb threat
• transfer from another hospital receiving blood to maintain vital signs
• penetrating injury to head, neck, torso, groin, other region

Burns

• over 10% BSA (2/3*) in patients under 10, over 50
• over 20% BSA (2/3*) in all others
• chemical/electrical burns
• airway involvement

Question 2

Criteria for level 2 trauma

Answer 2

MOI

• ejection
• adult fall greater than 20’
• child fall greater than 3x child height
• death in passenger cmpt
• pregnancy over 20 weeks with trauma MOI (i.e. Assault/MVC/etc.)
• deformity/intrusion of vehicle
• rollover MVC w/injury
• motor cycle collision over 20 mph
• motor cycle collision with separation of bike/rider
• auto v. Ped greater than 5 mph
• ped thrown/run over
• Burns over 5% BSA under 10 or over 50
• Burns over 10% BSA in all others