Trauma Triage

Question 1

Referring to adult trauma triage

Blunt or penetrating trauma with unstable vital signs
If one of the following are met:

Answer 1

• Penetrating or blunt trauma arrest at scene
• EMS witnessed arrest with blunt or penetrating trauma (Time of arrest must be
  conveyed in patch)
• GCS ≤ 13 and evidence of head trauma
• RR < 10 or > 30
• Blood pressure < 90
• Heart rate > 120

Transport to Trauma Centre
(Transport should not be delayed
waiting for ACP / Medical
Supervisor to arrive)

Question 2

Referring to adult trauma triage

Anatomical Injury
If one of the following are met:

Answer 2

• Penetrating injury to chest, neck, head, abdomen, groin or shoulder, including axilla
• Two or more proximal long bone fractures, i.e. humerus and/or femur
• Open fracture / open dislocation
• Fracture / dislocation with no pulse in affected limb
• Open book pelvic fractures/injuries
• Life-threatening chest injuries, i.e. flail chest, sucking chest wound, tension
  pneumothorax
• Major amputation of extremity, i.e. proximal to wrist or ankle
• Major extremity hemorrhage requiring CAT Tourniquet to control bleeding
• Paraplegia or quadriplegia
• Focal neurological deficits
• Pregnant patient sustaining any type of trauma excluding minor extremity trauma

Transport to Trauma Centre
(Transport should not be delayed
waiting for ACP / Medical
Supervisor to arrive)

Question 3

Referring to adult trauma triage

Mechanism of Injury criteria
If one of the following are met:

Answer 3

• Fall from a height > 10 ft. (1 storey is 10 ft.)
• Ejection (partial or complete) from a motorized vehicle
• Death in same passenger compartment
• Auto vs. Pedestrian/bicyclist thrown, run over, or with significant (>30 km/h) impact
• Intrusion > 12 inches at occupant location

Transport to Trauma Centre
(Transport should not be delayed
waiting for ACP / Medical
Supervisor to arrive)

Question 4

Referring to adult trauma triage

If one of the following criteria is met:

Answer 4

• Unable to maintain the airway or achieve adequate ventilation of the patient with prehospital interventions
• If death of patient appears imminent

Transport to closest hospital
(Transport should not be
delayed waiting for ACP /
Medical Supervisor to arrive)

Question 5

All potential and confirmed trauma triage patients require advanced communication with and notification of the Trauma Centre. The following is the process for the Trauma Pre-Alert Process:

Answer 5

Pre-Alert #1
- Communication on TACT 12
- First arriving unit on scene (Fire or EMS)
- After scene survey and prior to initiation of patient care
- Voice: “Trauma Pre-Alert, Trauma Pre-Alert”
- Identify Unit # and location
- Content: MOI, # of patients, ETA

Pre-Alert #2
- Communication on TACT 12
- Paramedic responsible for patient care to trauma patient
- After primary survey and initial treatment
- Voice: “Trauma Update”
- Identify Unit # and location
- Content (DEMIST Format)
- Demographics
- MOI
- Injuries
- Signs
- Treatment
- Updated ETA

Question 6

In the event of a false Pre-Alert #1 (over-triage), what do you do?

Answer 6

a second call to the Trauma Centre to “stand down” is required