LAC 48:I.19117. LERN Destination Protocol: Trauma

A. On November 21, 2013, 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 26, 2012, and repealing "LERN ENTRY CRITERIA, Trauma Pre-Hospital and Hospital Triage Protocol" adopted and promulgated April 21, 2011, as follows. 1. Call LERN Communication Center at (866) 320-8293 for patients meeting the following criteria. Unmanageable airway Tension pneumothorax Traumatic cardiac arrest Burn patient without patent airway Burn patient > 40 percent BSA without IV | Closest ED/Trauma Center NO 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 & ≥ 9 y/o) < 15 or > 30 (age 1 to 8 y/o) < 25 or > 50 (< 12 m/o) | To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center NO 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, 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 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) | To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center NO 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 | To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center NO 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 | To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center MULTI/MASS CASUALTY INCIDENT (MCI) | To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center B. This protocol was published at LR 40:190-191 (January 20, 2014).