Trauma Alert Notification Procedures

Question 1

Paramedic must relay this info to the receiving trauma center

Answer 1

Approximate age (patient must be 15 or older for ADULT trauma alert)*. Nature and mechanism of injury. Body area involved. GCS. Airway status. Hemodynamic status.

Question 2

Paramedic will notify dispatch immediately of trauma alert and will include this information

Answer 2

Adult or pediatric. #of patients. Mechanism of injury. Destination. Airway status. Hemodynamic status.

Question 3

Can a trauma alert be downgraded???

Answer 3

NO!!!

Question 4

1 point airway

Answer 4

sustained RR 30 or greater

Question 5

1 point circulation

Answer 5

sustained HR 120 or greater

Question 6

1 point Best motor response

Answer 6

BMR = 5

Question 7

1 point cutaneous

Answer 7

tissue loss major degloving injuries, major flap avulsion greater than 5 inches; GSW to extremities

Question 8

1 point long bone fracture

Answer 8

single fracture site due to MVA or single fracture site due to a fall greater than 10’

Question 9

1 point age

Answer 9

55 years old or greater

Question 10

1 point mechanism of injury

Answer 10

ejection from vehicle excluding motorcycle, ATV, bicycle or open truck bed OR deformed steering wheel for driver

Question 11

2 point Airway

Answer 11

Active assistance - not just O2

Question 12

2 point circulation

Answer 12

Lack of radial pulse with sustained HR of 120 or greater or BP sys less than 90

Question 13

2 point Best Motor Response

Answer 13

BMR = 4 or fewer; paralysis, suspected spinal cord injury, or loss of sensation.

Question 14

2 point cutaneous

Answer 14

Amputation proximal to wrist or ankle; 2nd or 3rd degree burns greater than 15% TBSA; any high voltage electrical/lightning injury; Penetrating injury to head, neck or torso excluding superficial wounds.

Question 15

Call a trauma alert if the patients GCS is less than or equal to what #???

Answer 15

12 or less; unless the patient is normally a 12 due to their medical history or pre-existing condition

Question 16

Call a trauma alert for what kind of neck laceration?

Answer 16

associated with swelling, sustained bleeding, escape of air from wound/stridor, and transport to NEAREST Trauma Center.

• if neck laceration does not meet this criteria take to trauma center but DO NOT call trauma alert.
• Treat ABC with rapid transport

Question 17

A trauma alert may be made with paramedic judgment when:

Answer 17

the senior care giver has a strong suspicion of injury in the patient; document “justified” reason on PCR left at the trauma center.

Question 18

Elder gray-area criteria Trauma Alert (generalized definition)

Answer 18

if older patient does not meet trauma alert criteria but is 65 years or older and possibly “at risk” and might benefit from a trauma center.

Question 19

Elder gray-area criteria Trauma Alert Mechanism of Injury

Answer 19

MVA with rapid deceleration (>35 MPH); pedestrian/bicycle/golf cart; motorcyclist; vehicle occupant with no restraints; significant passenger space invasion; extrication that exceeds 20 minutes; significant vehicular damage; Rollover; death of other occupant.

Question 20

Elder gray-area events associated with high-energy dissipation:

Answer 20

fall or blast

Question 21

Elder gray-area Injuries associated with an above mechanism such as fall or blast:

Answer 21

evidence of pelvic or chest trauma;

Question 22

Elder gray-area traumatic injury and currently taking:

Answer 22

anticoagulants and blood thinners; cardiac medications such as beta blockers and antiarrhythmics or any diabetic medications.

Question 23

Elder gray-area with medical history of:

Answer 23

Cardiac, CHF, COPD, Paralysis, Dementia, Surgical: any recent surgeries or a transplant recipient, diabetes

Question 24

Cardiac arrest in trauma to stop resuscitation

Answer 24

no pulse/signs of life, no pupil reflexes, asystole/agonal rhythm <20 bpm on monitor and multiple leads, patient becomes pulseless from traumatic injury when can’t be transported within 15 min, perform needle decompression prior to declaring termination/tension pnuemothorax is sometimes reversible cause of cardiac arrest. CALL MEDICAL CONTROL.

Question 25

crush injury patients:

Answer 25

a prolonged crush injury of 2 or more hours can cause hyperkalemia/acidosis and release potassium, myoglobin and other toxins into surrounding tissue from the cells causing arrythmias and death. Pain control, then administer Sodium bicarb 25 mEq just prior to removal of extremity then administer 500 mL bolus of NS. Maintain EKG on monitor and watch for signs of hyperkalemia; If present give another 25 mEq of Sodium Bicarbonate. 50 max.