Trauma Activation

Policy:

 

  • EMS providers shall assess each adult and pediatric trauma patient using the following criteria upon contact.
  • Once a level 1 trauma alert patient is identified in the field through assessment, a crew member must contact GMH via recorded line as soon as practical and provide a full report. The words “Trauma Alert” must be included in the report.
  • All patients meeting the criteria list below shall be transported to Greenville Memorial Hospital (Level 1 Trauma Center).
  • If patient refuses transport to GMH and is deemed a “Trauma Alert” by the EMS professional, a refusal must be signed for alternate transport destination after explaining the risk of “life and limb” to the patient.
  • Upon arrival in the Trauma bay EMS personnel will give a brief report to the trauma team by using the “M.I.S.T.” report.

 

Purpose:

 

  • To ensure the patient receives the appropriate care following traumatic injuries .

 

Trauma Criteria Level 1:

 

A Level 1 (Full) Alert should be activated on any patient meeting one or more of the following criteria:

 

  1. Glasgow coma score (GCS) ≤ 11
  2. Injury with associated Tachycardia and poor perfusion
  3. Systolic BP < 90 or for PEDS ≤ 70 + 2x (age in years
  4. Respiratory rate <10 or >29 or when the patient is in respiratory distress, has had a pleural decompression or is intubated.
  5. Penetrating injury /wound to head, neck, torso, or extremities proximal to the elbow or knee
  6. Paralysis related to trauma
  7. Crushed, de-gloving, mangled, or pulseless extremity proximal to the elbow & knee
  8. Thermal injuries including 2nd or 3rd degree burns ≥ 20% TBSA
  9. Electrocution with high voltage: ≥ 220 volts or > than household current
  10. Transferred patients receiving blood products related to trauma
  11. Active bleeding requiring a tourniquet or uncontrolled hemorrhage if injury is proximal to the elbow and/or knee.
  12. Discretion of any trauma team member

 

Evidence of Poor Perfusion

  • Skin pallor, cool extremities
  • Weak, distal pulses
  • Cyanosis/mottling, etc.

 

MIST REPORT