Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19101 - Entry Criteria and Region 4 LERN LCC Destination Protocol

Current through Register Vol. 50, No. 6, June 20, 2024
A. On November 15, 2007, the Louisiana
				  Emergency Response Network Board [R.S.
				  40:2842(1)] adopted and
				  promulgated "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol"
				  for region 4 of the Louisiana Emergency Response Network (R.S.
				  40:2842(3)), which region
				  includes the parishes of Acadia, Evangeline, Iberia, Lafayette, St. Martin, St.
				  Landry, and Vermilion, as follows.
1. LERN
				  Entry Criteria
LERN Entry Criteria
[] Unmanageable Airway
YES [RIGHTWARDS ARROW]
Call LCC
[] Tension Pneumothorax
[] Traumatic cardiac arrest
[] Burn patient without patent airway
[] Burn patient >40% BSA without IV
Neurologic Trauma
[] GCS <14 + one or more of the
								following:
YES [RIGHTWARDS ARROW]
Call LCC
[] Penetrating head injury or depressed skull
								fracture
[] Open head injury with or without CSF leak
[] Deterioration of the GCS
[] Lateralizing signs or paralysis (i.e., one-sided
								weakness, motor, or sensory deficit)
Physiologic
[] SBP <90 (adults and 9 y/o)
YES [RIGHTWARDS ARROW]
Call LCC
<70 + 2 [age (yrs)] (age 1 to 8)
<70 (age 1 to 12 months)
<60 (term neonate)
[] RR <10 or 29 (adults and 9 y/o)
<15 or 30 (age 1 to 8)
<25 or 50 (<12 m/o)
Anatomic
[] All penetrating injuries to neck, torso and
								extremities proximal to elbow and knee
YES [RIGHTWARDS ARROW]
Call LCC
[] Flail Chest
[] 2 or more proximal long-bone fractures
[] Crush, degloved or mangled extremity
[] Amputation proximal to wrist and ankle
[] Pelvic Fracture
[] Hip fractures (hip tenderness, deformity,
								lateral deviation of foot)
[] 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, etc.)
Mechanism
[] Falls >20 ft. (adults)
YES [RIGHTWARDS ARROW]
Call LCC
>10 ft. (child) or 2 to 3 times height
[] High -risk auto crash
Intrusion >12 in. occupant site:
>20 in. any site
[] Ejection, partial or complete from
								automobile
[] Death in same passenger compartment
[] Auto vs. pedestrian/bicyclist thrown, run
over or >5 MPH impact
[] Motorcycle crash >20 MPH
Special
[] Pregnancy >20 weeks
YES [RIGHTWARDS ARROW]
Call LCC
[] Burns (will follow ABA guidelines)
Other
[] Age >=55 y/o or <8 y/o
YES [RIGHTWARDS ARROW]
Call LCC
[] Anticoagulation and bleeding disorders
[] End stage renal disease
[] Transplant patients
2.
				  LERN Region 4 LCC Destination Protocol
LERN Region 4 LCC Destination
								Protocol
[] Unmanageable Airway
[] Tension Pneumothorax
[] Traumatic cardiac arrest
[] Burn p atient without patent airway
[] Burn patient 40 percent BSA without IV
YES [RIGHTWARDS ARROW]
Closest ED
NO
[DOWNWARDS ARROW]
Neurologic Trauma
[] GCS <14 + one or more of the
								following:
[] Penetrating head injury or depressed skull
								fracture
[] Open head injury with or without CSF leak
[] Deterioration of the GCS
[] Lateralizing signs or paralysis (i.e., onesided
								weakness, motor, or sensory deficit)
YES [RIGHTWARDS ARROW]
LERN Level II
NO
[DOWNWARDS ARROW]
LERN Region 4 LCC Destination
								Protocol
Physiologic
[] SBP <90 (adults and >9 y/o)
YES [RIGHTWARDS ARROW]
LERN Level II or III
<70 + 2 [age (yrs)] (age 1 to 8)
<70 (age 1 to 12 months)
<60 (term neonate)
[] RR <10 or 29 (adults and >=9 y/o)
<15 or >30 (age 1 to 8)
<25 or >50 (<12 m/o)
NO
[DOWNWARDS ARROW]
Anatomic
[] All penetrating injuries to neck, torso and
								extremities proximal to elbow and knee
YES [RIGHTWARDS ARROW]
LERN Level II or III
[] Flail Chest
[] 2 or more proximal long-bone fractures
[] Crush, degloved or mangled extremity
[] Amputation proximal to wrist and ankle
[] Pelvic Fracture
[] Hip fractures (hip tenderness, deformity,
								lateral deviation of foot)
[] 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, etc.)
[DOWNWARDS ARROW]
Mechanism
[] Falls >20 ft. (adults)
YES [RIGHTWARDS ARROW]
LERN Level II or III
>10 ft. (child) or 2 to 3 times height
[] High-risk auto crash
[] Intrusion >12 in. occupant site:
>20 in. any site
[] Ejection, partial or complete from
								automobile
[] Death in same passenger compartment
[] Auto vs. pedestrian/bicyclist thrown, run over
								or >5 MPH impact
[] Motorcycle crash 20 MPH
NO
[DOWNWARDS ARROW]
Special
[] Pregnancy 20 weeks
[] Burns (will follow ABA guidelines)
YES [RIGHTWARDS ARROW]
LERN
NO
[DOWNWARDS ARROW]
Other
[] Age=55 y/o or <8 y/o
YES [RIGHTWARDS ARROW]
LERN Level II, III or IV
[] Anticoagulation and bleeding disorders
[] End stage renal disease
[] Transplant patients