Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19117 - LERN Destination Protocol: Trauma

Current through Register Vol. 50, No. 6, June 20, 2024
A. On November 21, 2013, the Louisiana
				  Emergency Response Network Board [R.S.
				  40:2842(1) and (3)] adopted
				  and promulgated "LERN Destination Protocol: TRAUMA" replacing the "LERN
				  Destination Protocol: Trauma" adopted and promulgated April 26, 2012, and
				  repealing "LERN ENTRY CRITERIA, Trauma Pre -Hospital and Hospital Triage
				  Protocol" adopted and promulgated April 21, 2011, as follows.
1. Call LERN Communication Center at (866)
				  320-8293 for patients meeting the following criteria.
* Unmanageable airway
[RIGHTWARDS ARROW]
Closest ED/Trauma Center
* Tension pneumothorax
* Traumatic cardiac arrest
* Burn patient without patent airway
* Burn patient 40 percent BSA without IV
NO
[DOWNWARDS ARROW]
Physiologic
* GCS < 14
[RIGHTWARDS ARROW]
To Appropriate Trauma Center or Hospital as
								Determined by
LERN
Communication
Center
* SBP < 90 (adults and 9 y/o)
< 70 + 2 [age (yrs)] (age 1 to 8 y/o)
< 70 (age 1 to 12 months)
< 60 (term neonate)
* RR < 10 or >29 (adults & >=9
								y/o)
< 15 or >30 (age 1 to 8 y/o)
< 25 or >50 (< 12 m/o)
NO
[DOWNWARDS ARROW]
Anatomic
* Open or depressed skull fractures
[RIGHTWARDS ARROW]
To Appropriate Trauma Center or Hospital as
								Determined by
LERN
Communication
Center
* Open head injury with or without CSF leak
* Lateralizing signs or paralysis (i.e., onesided
								weakness, motor, or sensory deficit)
* All penetrating injuries to head, neck, torso,
								and extremities proximal to elbow and knee
* Flail Chest
* 2 or more proximal long-bone fractures
* Crush, degloved or mangled extremity
* Amputation proximal to wrist and ankle
* Pelvic Fractures
* Hip Fractures (hip tenderness, deformity, lateral
								deviation of foot) excluding isolated hip fractures from same level
								falls
* Major joint dislocations (hip, knee,
								ankle,elbow)
* Open Fractures
* Fractures with neurovascular compromise
(decreased peripheral pulses or prolonged capillary
								refill, motor or sensory deficits distal to fracture)
NO
[DOWNWARDS ARROW]
Mechanism
* Falls >20 ft. adults
[RIGHTWARDS ARROW]
To Appropriate Trauma Center or Hospital as
								Determined by
LERN
Communication
Center
>10 ft. (child) or 2 to 3 times height
* High-risk auto crash
* Intrusion >12 in. occupant site
>18 in. any site
* Ejection, partial or complete from
								automobile
* Death in same passenger compartment
* Auto vs. pedestrian/bicyclist thrown, run over or
								significant (>20 MPH) impact
* Motorcycle crash >20 MPH
NO
[DOWNWARDS ARROW]
Other
* Pregnancy >20 weeks
[RIGHTWARDS ARROW]
To Appropriate Trauma Center or Hospital as
								Determined by
LERN
Communication
Center
* Burns (follow ABA guidelines)
* Age >=55 y/o or <8 y/o
* Anticoagulation and bleeding disorders -patients
								w/ head injuries are at high risk for rapid deterioration
MULTI/MASS CASUALTY INCIDENT (MCI)
[RIGHTWARDS ARROW]
To Appropriate Trauma Center or Hospital as
								Determined by
LERN
Communication
Center