Trauma Tree

Question 1

Access Vital Signs / level of consciousness

Answer 1

Glasgow Coma Scale <14
Systolic BP <90
Respiratory rate <10 or >29 or equal too
<20 for infant <1 year , or need for ventilatory support.
PEDS Abnormal Appearance &/or Abnormal Work of Breathing &/or Abnormal Circulation

Question 2

Assess anatomy of injury

Answer 2

• All penetrating injuries to head,neck,torso, or extremities proximal of elbow or knee.
• Chest wall instability or deformity
• Two or more proximal long bone fractures
• Crush injury , degloved , or mangled, pulseless extremely
• Amputation proximal to wrist or ankle
• Pelvic fractures
• Open or depressed skull fractures
• Paralysis
• Neurologic / vascular defect of extremity
• Tourniquet applies to traumatic injury

Question 3

Assess mechanism of injury

Answer 3

• Fall >3 times patients height or >or equal too 15 feet
• Auto vs Pedestrian/ Bicyclist thrown, run over , or with significant (> or equal too 20 MPH) impact
• Motorcycle crash > or equal too 20 MPH
• Exposure to blast or explosion
• Combination trauma with burns

Question 4

Assess mechanism of injury

High Risk Auto Crash

Answer 4

• Intrusion, including roof
> or equal too 12 Inches , > or equal too 18 inches any site
• Ejection (partial or complete) from vehicle
• Death in same passenger compartment
• Vehicle telemetry data consistent with high risk injury
• Vehicle rollover with unrestrained patient

Question 5

Assess special considerations

Answer 5

• Age <5 or > or equal too 55
• Low impact mechanism
(ex ground level fall) > or equal too 65 Years old
• Bleeding disorder
• Anticoagulant or antiplatelet therapy (exempt ASA)
• Pregnancy > or equal too 20 weeks
• Poor Baseline physiologic reserve
(Severe cardiac and/or respiratory disease)
• Extrication time > or equal too 20 minutes
• EMS provider judgement