Trauma Center/ Air Ambulance Criteria Flashcards
What are the requirements for step one?
Glasgow Coma Scale, Systolic blood Pressure (mmHg), and Respiratory rate
Glasgow Coma Scale requirement?
≤13
Systolic Blood Pressure (mmHg) requirement?
<90 mmHg
Respiratory rate requirement?
<10 or >29 breaths per minute (<20 in infant ages <1 year), or need for ventilatory support
What is step two?
Assessing the anatomy for injuries
Where are you looking for penetrating injuries?
Head, neck, torso, and extremities proximal to elbow or knee
What are looking for in the chest wall?
instability or deformity (e.g. flail chest)
How many and type of fractures?
two or more proximal long bone fractures and pelvic fracture
Type of damage or findings to the extremities?
Crushed, degloved, mangled, or pulseless
Placement of amputation?
proximal to wrist and ankle
What type of skull fracture?
Open or depressed
What type of loss of ability?
Paralysis
What is step three?
Assessing the mechanism of injury and evidence of high-energy impact
Adults fall range?
> 20 feet
Children fall range?
> 10 feet or two or three times the height of the child
What type of high-risk auto crash?
intrusion, ejection, death in same passenger compartment, and vehicle telemetry data consistent with a high-risk injury
What type of auto vs. pedestrian/ bicyclist?
If pedestrian/ bicyclist thrown, run over, or significant impact?
what speed for motorcycle crash?
> 20 mph
What is step four?
Assessing special patients or system considerations
What happens after the age of 55?
Risk of injury/death increases
What may represent shock after the age of 65 years?
SBP <110
What may low impact mechanisms be a result of?
severe injury (e.g. ground level falls)
How should children be triaged?
To a pediatric capable trauma center
What are patients on anticoagulants and bleeding disorders at risk for?
patients with head injuries are at risk for rapid deterioration
What do you do with burn patients with no other trauma mechanism?
Triage to the burn facility
What do you do with burn patients with trauma mechanisms?
Triage to trauma center
How many weeks pregant should you transfer to a trauma center or hospital capable?
> 20 weeks
When should you consider helicopter EMS?
If anything meets any of the criteria from the CDC Guidelines for Field Triage or Injured Patients
What is not required for activating HEMS?
OLMD (Online Medical director)
What should installations have for rotary aircrafts?
A Primary, Alternate, Contingency, and Emergency HLZs that are established and/or predeterminedhelicopter landing zones
What should ambulances or fire apparatus be equipped with to provide alternate HLZ coordinates if needed?
A GPS
What patient diagnosis are inconsideration for Medical Launch?
Acute coronary syndrome, cardiogenic shock, cardiac tamponade, and mechanical cardiac disease
When should acute coronary syndrome be considered for medical launch?
The need for interventional therapy
When should cardiogenic shock be considered for medical launch?
The presence of a ventricular assist device or an intra-aortic balloon pump
when should cardiac tamponade be considered for medical launch?
When their is an impeding hemodynamic compromise
When should a mechanical cardiac disease be considered for medical launch?
When there is a valve failure, ventricular wall rupture, etc.
When should critically ill medical/surgical patients be transferred?
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
Who is apart of the special populations?
Neonatal, pediatric, obstetric, and neurologic patients
Where should special populations patients go to?
facilities that are capable of providing appropriate evaluation and treatment
