Patient < 16 years old?

• No
  • Follow Adult Trauma Triage and Transport Guidelines!
• Yes

• • Inability to manage or secure airway/oxygenation/ventilation?
  • Unmanageable signs/symptoms of shock?
  • Uncontrolled bleeding?

• Yes

• • Transport to GMMC. (Pediatric Trauma Center)

• No

• • Pediatric Glasgow Coma Scale PGCS ≤ 13
  • Decreased Level of Responsiveness (See AVPU Scale)
  • Penetrating trauma to head, neck, torso, or extremities proximal to knee or elbow
  • Proximal Long Bone Fractures - crushed, mangled, or degloved extremity - Amputation proximal to the wrist or ankle - Pelvic Fractures
  • Open or depressed skull fractures
  • Indications of significant closed head injury
  • Paralysis
  • Ejection of patient
  • Indications of significant chest or abdominal trauma
  • Auto vs. Pedestrian > 20 mph

• Yes
  • Transport to GMMC if within 60 minutes by ground

• No
  • ( if greater than 60 minutes)
  • Transport to Closest Trauma Center

• No

• • Fall > 10 feet or 2-3 times the height of a child
  • MVA with Intrusion > 12 inches roof, 18 inches of the passenger compartment (as outlined in 2011 CDC guideline)
  • Ejection from the vehicle (other occupant)
  • Death in the same vehicle
  • Mechanism consistent with high risk of injury
  • Inadequately restrained
  • Another occupant of the same vehicle is transported to a high level trauma center
  • Auto vs. Pedestrian < 20 mph
  • Motorcycle or motorized recreational vehicle.

• YES
  • Transport to GMMC, if within 30 minutes by ground

• • if not within 30 minutes by ground then Transport to the closet Trauma Center
• No
  • Special Circumstances
    • Burns
    • Pregnancy > 20 Weeks

• • Without other trauma mechanism: triage to appropriate facility
  • With trauma mechanism: triage to trauma center

Any injury not mentioned above shall be triaged and transported based on the EMS provider judgment - preferably with online medical direction - and according to local Protocols.