1. Critical Care and Paramedic Levels
Trauma Protocols
Critical Care and Paramedic Levels

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

3. Trauma: Transport Guidelines

4. 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

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

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

7. 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

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

9. Trauma: Chest
Fentanyl added

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

11. Trauma: Head Injury
No changes

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

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