LAC 48:I.19101. Entry Criteria and Region 4 LERN LCC Destination Protocol

A. On November 15, 2007, the Louisiana Emergency Response Network Board [R.S. 40:2842(1)] adopted and promulgated “LERN Entry Criteria” and "LERN Region 4 LCC Destination Protocol" for region 4 of the Louisiana Emergency Response Network (R.S. 40:2842(3)), which region includes the parishes of Acadia, Evangeline, Iberia, Lafayette, St. Martin, St. Landry, and Vermilion, as follows. 1. LERN Entry Criteria LERN Entry Criteria Unmanageable Airway Tension Pneumothorax Traumatic cardiac arrest Burn patient without patent airway Burn patient >40% BSA without IV | YES | Call LCC Neurologic Trauma GCS <14 + one or more of the following: Penetrating head injury or depressed skull fracture Open head injury with or without CSF leak Deterioration of the GCS Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit) | YES | Call LCC Physiologic SBP <90 (adults and > 9 y/o) <70 + 2 [age (yrs)] (age 1 to 8) <70 (age 1 to 12 months) <60 (term neonate) RR <10 or >29 (adults and > 9 y/o) <15 or >30 (age 1 to 8) <25 or >50 (<12 m/o) | YES | Call LCC Anatomic All penetrating injuries to neck, torso and extremities proximal to elbow and knee Flail Chest 2 or more proximal long-bone fractures Crush, degloved or mangled extremity Amputation proximal to wrist and ankle Pelvic Fracture Hip fractures (hip tenderness, deformity, lateral deviation of foot) Major joint dislocations (hip, knee, ankle, elbow) Open Fractures Fractures with neurovascular compromise (decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture, etc.) | YES | Call LCC Mechanism Falls > 20 ft. (adults) > 10 ft. (child) or 2 to 3 times height High-risk auto crash Intrusion > 12 in. occupant site: >20 in. any site Ejection, partial or complete from automobile Death in same passenger compartment Auto vs. pedestrian/bicyclist thrown, run over or >5 MPH impact Motorcycle crash >20 MPH | YES | Call LCC Special Pregnancy >20 weeks Burns (will follow ABA guidelines) | YES | Call LCC Other Age ≥55 y/o or <8 y/o Anticoagulation and bleeding disorders End stage renal disease Transplant patients | YES | Call LCC 2. LERN Region 4 LCC Destination Protocol LERN Region 4 LCC Destination Protocol Unmanageable Airway Tension Pneumothorax Traumatic cardiac arrest Burn patient without patent airway Burn patient >40 percent BSA without IV | YES | Closest ED NO Neurologic Trauma GCS <14 + one or more of the following: Penetrating head injury or depressed skull fracture Open head injury with or without CSF leak Deterioration of the GCS Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit) | YES | LERN Level II NO Physiologic SBP <90 (adults and > 9 y/o) <70 + 2 [age (yrs)] (age 1 to 8) <70 (age 1 to 12 months) <60 (term neonate) RR <10 or >29 (adults and ≥ 9 y/o) <15 or >30 (age 1 to 8) <25 or >50 (<12 m/o) | YES | LERN Level II or III NO Anatomic All penetrating injuries to neck, torso and extremities proximal to elbow and knee Flail Chest 2 or more proximal long-bone fractures Crush, degloved or mangled extremity Amputation proximal to wrist and ankle Pelvic Fracture Hip fractures (hip tenderness, deformity, lateral deviation of foot) Major joint dislocations (hip, knee, ankle, elbow) Open Fractures Fractures with neurovascular compromise (decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture, etc.) | YES | LERN Level II or III Mechanism Falls > 20 ft. (adults) > 10 ft. (child) or 2 to 3 times height High-risk auto crash Intrusion > 12 in. occupant site: >20 in. any site Ejection, partial or complete from automobile Death in same passenger compartment Auto vs. pedestrian/bicyclist thrown, run over or >5 MPH impact Motorcycle crash >20 MPH | YES | LERN Level II or III NO Special Pregnancy >20 weeks Burns (will follow ABA guidelines) | YES | LERN NO Other Age ≥ 55 y/o or <8 y/o Anticoagulation and bleeding disorders End stage renal disease Transplant patients | YES | LERN Level II, III or IV B. On June 26, 2008, the Louisiana Emergency Response Network Board passed a resolution allowing any region of the Louisiana Emergency Response Network which agreed to use the foregoing "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol" to begin operating using the "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol" set forth above. C. This protocol was published at LR 35:1181-1183 (June 20, 2009).