Field Trauma Triage Standard

Question 1

What are the physiological criteria in the FIRST point of this standard??

Answer 1

• patient does no follow commands
• systolic BP <90mmHg OR
• resp. rate <10 or >=30 breaths per minute and need for ventilatory (<20 in infant aged < 1 year)

Question 2

If patient doesn’t meet the criteria above, what type of criteria do we go to? (step 2)

Answer 2

ANATOMICAL

Question 2

If pt meets the criteria above AND the land transport time to LTH is <30mins away, what do we do?

Answer 2

TRANPOSRT TO LTH

Question 3

What is the anatomical criteria listed in step 2 of this standard?

Answer 3

• any penetrating injuries to head, neck or torso and extremities proximal to elbow or knee
• chest wall instability or deformity (flail chest)
• 2 or more proximal long-bone #’s
• crushed, de-gloved, mangled or pulseless extremity,
• amuptation proximal to wrist or ankle\
• pelvic fractures
• open or depressed skull fracture OR
• paralysis

Question 4

If pt meets the anatomical criteria listed ABOVE and the land transport time to LTH is less than 30 mins what do we do?

Answer 4

TRANSPORT TO LTH!!

Question 5

If you are unable to secure patients airway or survival to LTH (that is <30mins away) is unlikely, what should we do? and what is the ONLY exception to this??

Answer 5

transport to closest ED

only penetrating trauma to head neck or torso should you transport to LTH despite VSA patients

Question 6

What are the anatomical criteria that is required in STEP 2 of the standard? (8 things)

Answer 6

• any penetrating injuries to the head neck and torso and extremities proximal to elbow or knee
• chest wall instability or deformity (flail chest)
• 2 or more proximal long bone fractures
• crushed, de gloved, mangled or pulseless extremity
• amuptation proximal to wrist or ankle
• pelvic fractures
• open or depressed skull fracture
• paralysis

Question 7

If patient meets criteria above and the land transport time to LTH is less than 30 mins, what do we do?

Answer 7

TRANSPORT TO LTH

Question 8

If you are unable to secure pt airway and survival to LTH is unlikely what do we do?

Answer 8

Transport to closest ED

Question 9

If pt is VSA but has a penetrating injury to head neck or torso, where do we transport??

Answer 9

LTH if it is less than 30 mins away

Question 10

What MOI’s could determine a pt qualified for the LTH?

Answer 10

FALLS
- adults: greater or equal to 6 metres (1 story = 3 metres)
- children (<15) : greater or equal to 2-3 times the height of child

HIGH RISK AUTO CRASH
- T BONE
- ejection (partial or complete)
- death in the same passenger compartment
- vehicle telemetry data consistent with high risk injury

PEDESTRIAN OR BIKE THROWN, RUN OVER OR STRUCK with significant impact - >=30km/hr by an automobile

MOTORCYCLE crash >=30km/hr

Question 11

What are the special criteria in the last paragraph of this standard?

Answer 11

age:
- risk of injury/death increases after age 55
- SBP <110 may represent shock after age 65

anticoagulation and bleeding disorders

burns
- with trauma mechanism (triage to LTH)

pregnancy >=20 weeks