Trauma Center/ Air Ambulance Criteria

Question 1

What are the requirements for step one?

Answer 1

Glasgow Coma Scale, Systolic blood Pressure (mmHg), and Respiratory rate

Question 2

Glasgow Coma Scale requirement?

Answer 2

≤13

Question 3

Systolic Blood Pressure (mmHg) requirement?

Answer 3

<90 mmHg

Question 4

Respiratory rate requirement?

Answer 4

<10 or >29 breaths per minute (<20 in infant ages <1 year), or need for ventilatory support

Question 5

What is step two?

Answer 5

Assessing the anatomy for injuries

Question 6

Where are you looking for penetrating injuries?

Answer 6

Head, neck, torso, and extremities proximal to elbow or knee

Question 7

What are looking for in the chest wall?

Answer 7

instability or deformity (e.g. flail chest)

Question 8

How many and type of fractures?

Answer 8

two or more proximal long bone fractures and pelvic fracture

Question 9

Type of damage or findings to the extremities?

Answer 9

Crushed, degloved, mangled, or pulseless

Question 10

Placement of amputation?

Answer 10

proximal to wrist and ankle

Question 11

What type of skull fracture?

Answer 11

Open or depressed

Question 12

What type of loss of ability?

Answer 12

Paralysis

Question 13

What is step three?

Answer 13

Assessing the mechanism of injury and evidence of high-energy impact

Question 14

Adults fall range?

Answer 14

> 20 feet

Question 15

Children fall range?

Answer 15

> 10 feet or two or three times the height of the child

Question 16

What type of high-risk auto crash?

Answer 16

intrusion, ejection, death in same passenger compartment, and vehicle telemetry data consistent with a high-risk injury

Question 17

What type of auto vs. pedestrian/ bicyclist?

Answer 17

If pedestrian/ bicyclist thrown, run over, or significant impact?

Question 18

what speed for motorcycle crash?

Answer 18

> 20 mph

Question 19

What is step four?

Answer 19

Assessing special patients or system considerations

Question 20

What happens after the age of 55?

Answer 20

Risk of injury/death increases

Question 21

What may represent shock after the age of 65 years?

Answer 21

SBP <110

Question 22

What may low impact mechanisms be a result of?

Answer 22

severe injury (e.g. ground level falls)

Question 23

How should children be triaged?

Answer 23

To a pediatric capable trauma center

Question 24

What are patients on anticoagulants and bleeding disorders at risk for?

Answer 24

patients with head injuries are at risk for rapid deterioration

Question 25

What do you do with burn patients with no other trauma mechanism?

Answer 25

Triage to the burn facility

Question 26

What do you do with burn patients with trauma mechanisms?

Answer 26

Triage to trauma center

Question 27

How many weeks pregant should you transfer to a trauma center or hospital capable?

Answer 27

> 20 weeks

Question 28

When should you consider helicopter EMS?

Answer 28

If anything meets any of the criteria from the CDC Guidelines for Field Triage or Injured Patients

Question 29

What is not required for activating HEMS?

Answer 29

OLMD (Online Medical director)

Question 30

What should installations have for rotary aircrafts?

Answer 30

A Primary, Alternate, Contingency, and Emergency HLZs that are established and/or predeterminedhelicopter landing zones

Question 31

What should ambulances or fire apparatus be equipped with to provide alternate HLZ coordinates if needed?

Answer 31

A GPS

Question 32

What patient diagnosis are inconsideration for Medical Launch?

Answer 32

Acute coronary syndrome, cardiogenic shock, cardiac tamponade, and mechanical cardiac disease

Question 33

When should acute coronary syndrome be considered for medical launch?

Answer 33

The need for interventional therapy

Question 34

When should cardiogenic shock be considered for medical launch?

Answer 34

The presence of a ventricular assist device or an intra-aortic balloon pump

Question 35

when should cardiac tamponade be considered for medical launch?

Answer 35

When their is an impeding hemodynamic compromise

Question 36

When should a mechanical cardiac disease be considered for medical launch?

Answer 36

When there is a valve failure, ventricular wall rupture, etc.

Question 37

When should critically ill medical/surgical patients be transferred?

Answer 37

Post cardiac/respiratory arrest, a requirement for IV vasoactive medications or mechanical ventilation, risk for airway deterioration, severe poisoning/overdose requiring specialized toxicology services, urgent need for hyperbaric oxygen therapy, requirement for emergent dialysis, gastrointestinal hemorrhage with hemodynamic instability, surgical emergencies

Question 38

Who is apart of the special populations?

Answer 38

Neonatal, pediatric, obstetric, and neurologic patients

Question 39

Where should special populations patients go to?

Answer 39

facilities that are capable of providing appropriate evaluation and treatment