Trauma Triage

Question 1

What Age Do You have to transport a pediatric to UCD

Answer 1

14 - Less than or equal

Question 2

If a pt has a tourniquet do you have to transport them to a trauma center

Answer 2

Yes

Question 3

When can you divert from trauma center and go to closest hospital

Answer 3

Non effective airway - s, i.e. obstructed airway or
unrelieved tension pneumothorax.

Question 4

What do you do if your critical trauma pt refuses to go to trauma center

Answer 4

Direct medical oversight shall be obtained from a SCEMSA-designated trauma center f

Question 5

If trauma pt has an LVAD where do you take them

Answer 5

UCD

Question 6

Physiological Trauma Criteria

Answer 6

Unable to follow commands (motor GCS < 6)
Respiratory rate <10 or >29 breaths per minute
Respiratory distress or need for respiratory support
Note: “Respiratory support: Anything other than supplemental 02
Sustained heart rate > 120 beats per minute
Room-air pulse oximetry < 90
Age 0-9: SBP < 70mm Hg + (2x age years)
Age 10-64 years: SBP < 90 mmHG OR HR > SBP
Age ≥ 65 years: SBP < 110 mmHg OR HR > SBP

Question 7

Anatomic Trauma Triage Criteria

Answer 7

All penetrating injuries to the head, neck, torso, and
extremities proximal to the elbow and knees
* Skull deformity, suspected skull fracture
* Suspected Flail Chest, wall instability, or deformity
* Suspected fracture of Two or more proximal long-bone
* Crushed, de-gloved, mangled, or pulseless extremity
proximal to wrist or ankle, or pulseless extremity
* Amputation proximal to wrist or ankle
* Suspected pelvic fracture
* Suspected spinal injury with new motor or sensory loss
* Active bleeding requiring a tourniquet or wound packing
with continuous pressure

Question 8

Mechanism Trauma Criteria

Answer 8

• Falls
  Adults: > 10 feet (one story is equal to 10 feet)
  Children: > 10 feet
  Low level falls in young children (age ≤ 5 years) or older
  adults (age ≥ 65 years) with significant head impact
• High risk auto crash
  Intrusion: >12 inches occupant site; > 18 inches any site
  (including roof)
  NOTE: Intrusion refers to interior compartment intrusion, as
  opposed to deformation which is exterior damage.
• Ejection (partial or complete) from motorized vehicle or livestock
• Death in same passenger compartment
• Child (Age 0-9) unrestrained or in unsecured child safety seat)
• Auto vs. pedestrian/bicyclist thrown , run over, or with significant
  (>20 mph) impact
• Motorcycle crash > 20 mph

Question 9

Critical Trauma Patients who do not meet
physiological criteria with the following conditions
will be transported to UCDMC:

Answer 9

Traumatic amputations proximal to the wrist and/
or the ankle
- Traumatic burns > 9% Total Body Surface Area
- Chemical or Electrical Burns
- Evidence of possible inhalation injury
- Any Burn to the face, hands, feet, genitalia,
perineum or major joints

Question 10

Patients ≤ fourteen (14) years of age will be
transported to UCDMC if they meet any trauma
triage condition with the following exceptions:

Answer 10

Pediatric Critical Trauma patients with no effective
established airway may be transported to the
closest available facility excluding the VA per
PD# 5050.
- Regardless of age, Traumatic Cardiopulmonary
Resuscitation patients shall be transported to the
time closest designated trauma center.

Question 11

EMS Provider Judgement to take to trauma center - Examples

Answer 11

Patients taking anticoagulation medications,
excluding aspirin, or a history of bleeding disorders.
A clear history of loss of consciousness.
Pregnancy > 20 weeks.