Time Critical Guidelines

Question 1

Types of time critical situations

Answer 1

• Major trauma
• Significant medical conditions
• Requirements for specialised resources such as AMR, HEMS, ICP
• Judicious scene Mx

Question 2

Three time critical definitions

Answer 2

1. Actual: physiological distress at the time VSS is taken.
2. Emergent: VSS is not physiologically distressed, however, significant pattern of injury or illness is known to cause deterioration.
3. Potential: VSS is not physiologically distressed, however, injury or illness has the potential to potentiate into deterioration.

Question 3

Actual time critical vital signs

Answer 3

• SBP <90mmHg
• HR <50 or >120
• SpO2 <90%
• RR <12 or > 24
• GCS 13 or less

Question 4

Significant injuries causing emergent criticality

Answer 4

• Penetrating injuries to head, neck, chest, abdomen, groin, pelvis.
• Blunt injuries
• Limb amputation
• Suspected SCI
• Burns >20% TBSA
• Serious crush injury
• Compound fracture or open dislocation
• Fractured pelvis

Question 5

Medical emergent time critical conditions

Answer 5

• ACS
• Stroke
• Severe sepsis including meningococcal
• AAA
• Undiagnosed pain
• Acute asthma/COPD
• Hypo-/hyperthermia

Question 6

MOI for potential time critical injuries

Answer 6

• Cyclist or MBA >30km/hr
• Pedestrian hit
• MVA >60km/hr
• Fall >3m
• Object hits head >3m above
• Rollover
• Fatality in the same car
• Ejection
• Explosion
• Electrocution >30mins

Question 7

Co-morbidities contributing to Trauma Triage pre-notification

Answer 7

• Systemic conditions: T2DM, HTN, morbidly obese, CCF,COPD, IHD, Renal or cirrhosis.
• Pregnancy
• <16 years or >60 years