35.2 FIELD TRIAGE OF TRAUMA / DESTINATIONS / ACTIVATION
All Providers
- After scene size up notify potential receiving facilities of number/nature of injuries
- Activation of aeromedical transport for LEVEL 1 ACTIVATION should be considered
- LEVEL 1 ACTIVATIONS should be preferentially transported to closest TRAUMA HOSPITAL
Level 1 Activation
- GCS < 11 or less than V on AVPU
- Systolic blood pressure < 90 mmHg
- Respiratory rate < 10 or> 29 breaths/minute (< 20 in infant)
- Penetrating injuries to head, neck, torso,extremities proximal to knee/elbow
- Active bleed requiring tourniquet and/or wound packing with continuous pressure
- Two or more proximal long bone fractures
- Flail chest
- Crushed, degloved, or mangled extremity
- Amputation proximal to wrist/ankle
- Pelvic fractures>
- Open or depressed skull fracture
- Paralysis
- Aeromedical launched by EMS
- Severe facial injuries
Level 2 Activation
- GCS >10 and <14 secondary to trauma
- Falls > 10 feet
-
High-risk auto crash
- intrusion >12 inches
- ejection
- death in same passenger compartment
- Extrication time > 20 minutes
- Age > 55
- Child unrestrained or unsecured child safety seat (0-9 years)
- Burns
- Tourniquet use
- Anticoagulation or bleeding disorders
- Dialysis patient
- Pregnancy > 20 weeks
-
Auto vs. pedestrian or bicyclist
- thrown, run over, or > 20 mph
- motorcycle crash > 20 mph
- Provider judgment