Critical Care and Paramedic Levels

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Presentation transcript:

Critical Care and Paramedic Levels Trauma Protocols Critical Care and Paramedic Levels

Trauma: Unstable Patients Traumatic Arrest/Unstable Airway Closest facility Transport unstable patients to hospital/landing zone within 10 minutes of extrication

Trauma: Transport Guidelines

Trauma: General Guidelines Prolonged transport Consider aeromedical utilization > 45 minutes by ground and air not available Call medical direction – consider transporting to closest emergency department Transporting trauma to non-trauma center Notify emergency department as early as possible

Trauma: Aeromedical Utilization Must SIGNIFICANTLY reduce transport time Signs of life!!! Don’t wait for the helicopter <20 mile transport? Entrapment

Trauma: Pregnant Patients Adult trauma pt > 20 weeks gestation Not meeting trauma criteria – ER of their choice Meeting trauma criteria – Adult trauma center!

Trauma: Burn Patients Burn Criteria for transport to burn center >10% BSA partial thickness burns Involvement of face, hands, feet, genitalia, or major joints Third degree burns Electrical burns, including lightning injuries Chemical burns Inhalation injury Circumferential burns

Trauma: Burn Management Fentanyl added Less BP effect Med control only Rigid chest with rapid push

Trauma: Chest Fentanyl added

Trauma: Crush Injury New Protocol For prolonged entrapment only Tourniquet use? Pre-medicate

Trauma: Head Injury No changes

Trauma: Extremity Injury Tourniquet use Hemostatic dressing Once applied do not remove Fentanyl added

Trauma: Hypoperfusion Differing fluid goals for compressible injury Reflects current ITLS/ATLS guidelines