LAC 48:I.19115. LERN Destination Protocol: TRAUMA

A. On April 26, 2012, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and (3)] adopted and promulgated "LERN Destination Protocol: Trauma" replacing the "LERN Destination Protocol: Trauma" adopted and promulgated April 21, 2011, as follows. Unmanageable Airway Tension Pneumothorax Traumatic cardiac arrest Burn Patient without patent airway Burn patient >40 percent BSA without IV | Closest ED Physiologic GCS <14 SBP <90 (adults and > 9 y/o) <70 + 2 [age (yrs)] (age 1 to 8 y/o) <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 y/o) <25 or >50 (<12 m/o) | Level I, II, or III* Anatomic Open or depressed skull fractures Open head injury with or without CSF leak Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit) All penetrating injuries to head, neck, torso, & extremities proximal to elbow & knee Flail Chest 2 or more proximal long-bone fractures Crush, degloved or mangled extremity Amputation proximal to wrist & ankle Pelvic Fractures Hip Fractures (hip tenderness, deformity, lateral deviation of foot) excluding isolated hip fractures from same level falls 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) | Level I, 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 > 18 in. any site Ejection, partial or complete from automobile Death in same passenger compartment Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 MPH) impact Motorcycle crash >20 MPH | Level I, II, or III* Other Pregnancy >20 weeks Burns (follow ABA guidelines) Age ≥ 55 y/o or <8 y/o Anticoagulation and bleeding disorders -patients w/ head injuries are at high risk for rapid deterioration | Level II, or III* MULTI/MASS CASUALTY INCIDENT (MCI) | Level I, II, or III* *Refers to ACS Verified Level Trauma CenterWhere trauma center not available, patient will be routed to facility with appropriate resource which may not need be the highest level facility. B. This protocol was published at LR 38:1462-1463 (June 20, 2012).