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 K - COMPREHENSIVE STROKE CENTERS, PRIMARY STROKE CENTERS AND ACUTE STROKE-READY HOSPITALS › Appendix F - Template for In-House Triage for Trauma Centers

Current through Register Vol. 48, No. 28, July 12, 2024
It is expected that each trauma center will expand upon the
				  minimum triage set based on individual assessments, resources and outcomes. The
				  criteria are consistent with the Minimum Trauma Field Triage Criteria for
				  transport to a trauma center.
a) Patient Evaluation
1) Any EMS System transported patients who are
				  classified under Category I in the Minimum Trauma Field Triage Criteria require
				  rapid transport to a trauma center if less than 25 minutes from the trauma
				  center; otherwise, follow Section 515.Appendix C. Mandatory field notification
				  of a trauma surgeon will occur in cases of:
A) Sustained hypotension (blood pressure less than
				  or equal to 90 Hg systolic for an adult and less than or equal to 80 Hg for a
				  pediatric patient on two consecutive measures five minutes apart); or
B) Cavity penetration of the torso or neck.
2) Patients who are classified in the field or in
				  any pre-hospital setting shall be evaluated by the ED's attending emergency
				  physician or designee immediately upon arrival. (Section 515.2060(a))
3) Patients who are not classified as trauma prior
				  to arrival shall be evaluated to assess whether they should be classified as a
				  trauma patient within 10 minutes after arrival. (Section 515.2060(b))
4) Within the above 10 minute evaluation period,
				  the patient must be determined to be Category I or Category II. The response
				  periods for both categories are described below.
5) Patients may be upgraded at any time during ED
				  treatment. The surgeon response time requirements begin at the time of
				  upgrade.
6) Once the patient has been assigned a Category I
				  or II status that patient cannot be downgraded until the patient is evaluated
				  by the trauma surgeon or appropriate subspecialist.
b) Category I
The trauma center must activate its trauma team
				  response (which includes a trauma surgeon, resident or other surgical specialty
				  in lieu of the trauma surgeon) for patients who meet these criteria. Level II
				  trauma centers require a 30-minute response from the time of identification of
				  need. If a back-up surgeon is used, the 30-minute time for response is based on
				  the trauma patient identification time, not the time of the contact to the
				  back-up surgeon. Any patient can be made a Category I based on the ED
				  physician's discretion.
Any patient meeting the definition of isolated
				  injury requires consultation with the appropriate subspecialist within 60
				  minutes after trauma patient identification, except for neurosurgery and Level
				  I OB/GYN, pediatric surgery and cardiovascular surgery. When neurosurgical
				  intervention has been identified, the neurosurgeon must arrive and be available
				  in a fully staffed operating room within 60 minutes after the identification of
				  the need for operative intervention. In a Level I trauma center, the OB/GYN,
				  pediatric surgery or cardiovascular surgical subspecialist must arrive within
				  30 minutes after notification of the subspecialist that his or her services are
				  needed at the hospital. Where specialty services are provided by transfer
				  agreement, a transfer to a specialty center shall commence within 30 minutes
				  after the patient's arrival, and shall be completed within two hours. An
				  isolated injury refers to transfer of energy to a single anatomic body region
				  with no potential for multisystem involvement.
c) Category II
Any other patient who is admitted for traumatic
				  injury requires notification/consultation with the trauma surgeon or
				  subspecialist at the time the decision to admit is made. The patient will be
				  seen by the trauma surgeon or appropriate surgical subspecialist within 12
				  hours after emergency department arrival.
Any patient meeting the definition for isolated
				  injury requires a telephone consultation with the appropriate subspecialist
				  (within 60 minutes Level II and 30 minutes Level I) of identified need by the
				  emergency department physician. When the need for neurosurgical intervention
				  has been identified, the neurosurgeon must be available in a fully staffed
				  operating room within 60 minutes after the identification of need for operative
				  intervention. Where specialty services are provided by transfer agreement, a
				  transfer to a specialty center shall commence within 30 minutes after the
				  patient's arrival, and the transfer shall be completed within two hours. An
				  isolated injury refers to the transfer of energy to a single anatomic body
				  region with no potential for multisystem involvement.
Category I criteria include at minimum but are not
				  limited to items in the Category I box, Minimum Trauma Field Triage Criteria
				  (Section 515.Appendix C).
Category II criteria include at minimum but are
				  not limited to items in the Category II box, Minimum Field Triage Criteria
				  (Section 515.Appendix C).