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WHEN THE HIGHEST LEVEL OF CARE IS NEEDED

EMS personnel do triage in determining the severity of a patient’s injuries or conditions, helping them determine whether or not they should be transported to the highest-level trauma center available within the geographic constraints of the regional trauma system. Criteria is established by the American College of Surgeons.

The types of injuries or conditions that would call for the highest level of trauma care available include:

■ Penetrating injuries to head, neck, torso and proximal extremities

■ Skull deformity, suspected skull fracture

■ Suspected spinal injury with new motor or sensory loss

■ Chest wall instability, deformity, or suspected flail chest

■ Suspected pelvic fracture

■ Suspected fracture of two or more proximal long bones

■ Crushed, degloved, mangled, or pulseless extremity

■ Amputation proximal to wrist or ankle

■ Active bleeding requiring a tourniquet or wound packing with continuous pressure

Patients who are unable to follow commands, are in respiratory distress and/or have an abnormally high or low heart rate for their age range are recommended to go to the highest level of trauma care available in their area.

WHEN ANY LEVEL OF TRAUMA CARE WILL DO

EMS personnel can take patients with less severe injuries or conditions to any trauma center, and they do not have to be the highest level available. The factors taken into consideration in that situation include:

■ High-risk auto crashes

■ Rider separated from transport vehicle with significant impact (eg, motorcycle, ATV, horse, etc.)

■ Pedestrian/bicycle rider thrown, run over, or with significant impact

■ Fall from height greater than 10 feet (all ages)

■ Low-level falls in young children (age 5 years or younger) or older adults (age 65 years or older) with significant head impact

■ Anticoagulant use

■ Suspicion of child abuse

■ Special, high-resource healthcare needs

■ Pregnancy greater than 20 weeks

■ Burns in conjunction with trauma