Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 40 - Comprehensive Emergency Medical Services Systems Regulations › Section 19 CSR 30-40.792 - Adult Trauma and Pediatric Field Triage and Transport Protocol

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes protocols for
				  transporting suspected trauma patients by severity and time of onset to the
				  trauma centers where resources exist to provide appropriate
				  care.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) All ground and air ambulances shall use
				the Adult and Pediatric Trauma Field Triage and Transport Protocol unless the
				department has waived the requirements of the rule pursuant to section
				190.200.3, RSMo, and
				19 CSR
				30-40.790.
(A)
				Assess for life-threatening conditions (such as serious airway or respiratory
				compromise or immediate life-threatening conditions that cannot be managed in
				the field).
1. If there are life-threatening
				conditions, then transport patient to the closest trauma center or hospital
				emergency department capable of managing the condition.
2. If there are no life-threatening
				conditions, then assess the patient using the 2021 National Guideline for the
				Field Triage of Injured Patients, which is incorporated by reference in this
				rule as published by the American College of Surgeons and available online at
www.facs.org/quality-programs/trauma/
				systems/field-triage-guidelines/
or from the American College of
				Surgeons, 633 N. Saint Clair St., Chicago, Illinois 60611-3295. This rule does
				not incorporate any subsequent amendments or additions.
A. If the patient is fifteen (15) years of
				age or older and meets any one (1) of the listed red criteria, then transport
				the patient to a level I or II trauma center according to local and regional
				process. If the patient is younger than fifteen (15) years old, then transport
				to a level I or II pediatric trauma center or a level I or II pediatric capable
				trauma center according to local and regional process. A pediatric capable
				trauma center is an adult trauma center designated by the department that
				admits fewer than one hundred (100) injured children younger than fifteen (15)
				years of age. The local and regional process shall take into consideration time
				for transport, patient condition, and treatment window (within 60 minutes from
				time of injury to the appropriate trauma center) with the goal to secure the
				appropriate treatment for the patient as expeditiously as possible via ground
				and/or air. The local and regional process for bi-state regions accounts for
				out-of-state transport when appropriate.
B. If the patient is fifteen (15) years of
				age or older and meets any one (1) of the listed yellow criteria, then
				transport the patient to a level I, II or III trauma center. If the patient is
				less than fifteen (15) years old, then transport to a level I, II, or III
				pediatric trauma center or a level I, II or III pediatric capable trauma center
				according to local and regional process. Local and regional process shall take
				into consideration time for transport, patient condition, and treatment window
				(within 60 minutes from time of injury to the appropriate trauma center) with
				the goal to secure the appropriate treatment for the patient as expeditiously
				as possible via ground and/or air. The local and regional process for bi-state
				regions accounts for out-of-state transport when appropriate.