Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19123 - LERN Destination Protocol: TRAUMA

Current through Register Vol. 50, No. 6, June 20, 2024
A. On
				  August 18, 2022, the Louisiana Emergency Response Network Board [R.S.
				  40:2842(1) and (3)] adopted
				  and promulgated "LERN Destination Protocol: TRAUMA", and replacing the "LERN
				  Destination Protocol: TRAUMA" adopted and promulgated December 10, 2015, as
				  follows:
1. Call LERN Communication Center at
				  (866) 3208293 for patients meeting the following criteria.
Assess for
								Extremis
* Unmanageable airway
* Tension pneumothorax
* Traumatic cardiac arrest
* Burn patient without patent airway
* Burn patient > 40 percent BSA without IV or IO
								Access
Yes
[RIGHT ARROW]
Closest ED/Trauma Center
No
[DOWN ARROW]
Measure vital signs and Mental
								Status
* Unable to follow commands (Motor GCS
								<6)
* RR <10 or > 29 breaths per minute (<20
								in infant aged <1 year)
Yes
[RIGHT ARROW]
Transport to Trauma Center/ Trauma
								Program
These patients should be transported to the highest
								level of care within the defined trauma system. This is a Level 1 or a Level 2
								Trauma Center or Trauma Program.
* Respiratory distress or need for support
* Room air pulse oximetry <90%
* Age 0-9: SBP <70 mmHG + (2 x age in
								years)
* Age 10-64: SBP <90 mmHG or HR > SBP
* Age [GREATER THAN EQUAL TO] 65: SBP <110 mmHG
								or HR SBP
* If distance or patient condition impedes
								transport to Level 1 or 2, consider transport to a Level 3 Trauma Center/Trauma
								Program or most appropriate resourced hospital.
No
[DOWN ARROW]
Assess Injury
								Patterns
* All penetrating injuries to head, neck, torso,
								and extremities proximal to elbow or knee
* Chest wall instability or deformity or suspected
								flail chest
* Suspected fracture of two or more proximal
								long-bones
* Crushed, de-gloved, mangled, or pulseless
								extremity
* Amputation proximal to wrist or ankle
* Suspected pelvic fracture
* Skull deformity or suspected skull
								fracture
* Suspected spinal injury with new motor or sensory
								loss
* Active bleeding requiring a tourniquet or wound
								packing with continuous pressure
Yes
[RIGHT ARROW]
Transport to Trauma Center/ Trauma
								Program
These patients should be transported to the highest
								level of care within the defined trauma system.
This is a
Level I or a Level 2
Trauma Center or
Trauma Program.
* If distance or patient condition impedes
								transport to Level 1 or 2, consider transport to a Level 3 Trauma Center/Trauma
								Program or most appropriate resourced hospital
No
[DOWN ARROW]
Assess mechanism of
								injury
* Falls from height >10 feet (all ages)
* High-risk auto crash
-- Intrusion, including roof:
- 12 inches occupant site;
- 18 inches any site;
-need for extrication for patient entrapped
- Ejection (partial or complete) from
								automobile
- Death in the same passenger compartment
- Child (Age 0-9)unrestrained or in unsecured child
								safety seat
- Vehicle telemetry data consistent with a high
								risk of injury
* Auto vs. pedestrian/bicyclist thrown, run over,
								or with significant (20 mph) impact
* Rider separated from transport vehicle with
								significant impact (ex: motorcycle, ATV, Horse, etc.)
Yes
[RIGHT ARROW]
Transport to Trauma Center/Trauma
								Program
which, depending upon the defined trauma system, need not be the
								highest level trauma center/program. If no Trauma Center/Trauma Program in the
								region, LCC may route to the most appropriate resourced hospital.
No
[DOWN ARROW]
Assess special patient or
								system considerations
* Older Adults
- Age [GREATER THAN EQUAL TO] 65 with evidence of
								traumatic injury
- Fall from any height with evidence of significant
								head impact
- Use of anticoagulant or antiplatelet drugs
* Children
- Age [LESS THAN EQUAL TO] 5 with evidence of
								traumatic injury
- Fall from any height with evidence of significant
								head impact
* Burns
- In conjunction with trauma
- High voltage electrical injuries
* Pregnancy 20 weeks
* Major joint dislocations (hip, knee, ankle,
								elbow)
* EMS provider judgment
Yes
[RIGHT ARROW]
Transport to Trauma Center/Trauma
								Program
or hospital capable of timely and thorough evaluation and
								initial management of potentially serious injuries. Consider consultation with
								medical control.
No
[DOWN ARROW]
Multi/Mass Casualty Incident
No
Transport according to protocol
2.
				  When in doubt, transport to a trauma center.