Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 515 - EMERGENCY MEDICAL SERVICES, TRAUMA CENTER, COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER AND ACUTE STROKE READY HOSPITAL CODE › Subpart H - TRAUMA CENTERS › Section 515.2060 - Trauma Patient Evaluation and Transfer

Current through Register Vol. 48, No. 28, July 12, 2024
a) Patients who are determined in the
				pre-hospital setting to have sustained hypotension or are victims of cavity
				penetration of the neck or torso or any other trauma patient as deemed by
				medical control shall be classified as trauma patients in the field. The trauma
				surgeon response time begins at the time of field classification. The patient
				shall be immediately evaluated upon arrival at the ED.
b) Patients who are not classified in the
				field must be evaluated within 10 minutes after arrival at the trauma center.
				This evaluation shall be conducted by the attending ED physician or designee.
				"Designee", for the purposes of this Section, may refer to ED staff including,
				but not limited to, a surgeon acting as the ED attending, resident physician,
				Physician Assistant, or Registered Nurse. By the time the 10 minute evaluation
				period has elapsed, the patient must be determined to be a Category I trauma
				patient (Section 515.Appendices C and F of this Part) or Category II (Section
				515.Appendix C) or not to have met either Category I or II criteria. A patient
				cannot be downgraded once a category has been assigned. Upgrade to a Category I
				or II may occur at any time the patient's condition warrants. The trauma or
				specialty surgical response time begins at the time of upgrade.
c) EMS Regions or trauma centers may develop
				triage criteria that expand Category I and II criteria but may not delete any
				of the minimal criteria in Section 515.Appendix C of this Part.
d) The response period for trauma or
				specialty surgery for Category I or II patients is as specified in Section
				515.2030(c),
				Section
				515.2040(c)
				and Section 515.Appendix F of this Part.
e) Trauma patients being transferred to a
				Level I or Level II facility or to more specialized care should be enroute
				within two hours after arrival when stabilized within the capabilities of the
				referring institution.
f) The
				Revised Trauma Score, as specified by the American College of Surgeons, shall
				be used in all trauma centers. The Revised Trauma Score is determined by using
				the following criteria:
Value
Points
1)
Respiratory Rate
10-29/Min
4
>29/Min
3
6-9/Min
2
1-5/Min
1
0
0
2)
Systolic Blood Pressure
greater than 89mmHg
4
76-89mmHg
3
50-75mmHg
2
1-49mmHg
1
no pulse
0
3)
Glasgow Coma Scale
A)
Eye Opening Response
Points
Spontaneous
4
To Voice
3
To Pain
2
None
1
B)
Best Verbal Response
Oriented
5
Confused
4
Inappropriate Words
3
Incomprehensible Sounds
2
None
1
C)
Best Motor Response
Obeys Commands
6
Localizes (Pain)
5
Withdraw (Pain)
4
Flexion (Pain)
3
Extension (Pain)
1
None
1
Total GCS
Revised Trauma
Points
13-15
=
4
9-12
=
3
6-8
=
2
4-5
=
1
<4
=
0
4)
Revised Trauma Score = Total Points 1 + 2 + 3
g)
				Each EMS Region may include other criteria in addition to the Revised Trauma
				Score in defining a trauma patient and specifying where trauma patients should
				be transported according to the severity of the injury.
h) The components of Section 515.Appendix D
				of this Part shall be included in the trauma center policy.