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Trauma Decision Tree
Trauma Decision Tree Maryland Medical Protocols for EMS Providers July 1, 2010
Question | Answer |
---|---|
GCS less than or equal to 8 | Category A Trauma |
Respiratory rate less than 10 or greater than 29 | Category A Trauma |
Systolic BP less than 90 (Adult) less than 60 (Peds) | Category A Trauma |
Flail chest | Category A Trauma |
Pelvic fracture | Category A Trauma |
Penetrating injuries to head, neck, or torso | Category A Trauma |
Rapidly declining GCS | Category A Trauma |
Paralysis (spine) | Category A Trauma |
Open or depressed skull fracture | Category A Trauma |
2 or more proximal long-bone fractures | Category A Trauma |
GCS 9 - 14 | Category B Trauma |
Paralysis or vascular compromise of limb | Category B Trauma |
Amputation proximal to wrist or ankle | Category B Trauma |
Crushed, degloved, or mangled extremity | Category B Trauma |
Penetrating injuries to extremities proximal to elbow or knee | Category B Trauma |
Combination trauma with burns | Category B Trauma |
PIC - Intrusion greater than 12 in. occupant site; greater than 18 in. any site | Category C Trauma |
PIC - Ejection (partial or complete) from vehicle | Category C Trauma |
PIC - Death in same passenger compartment | Category C Trauma |
PIC - Vehicle telemetry data consistent with high risk of injury | Category C Trauma |
Falls greater than 3 times patient’s height | Category C Trauma |
Exposure to blast or explosion | Category C Trauma |
PIC - Rollover without restraint | Category C Trauma |
PIC - Auto v. pedestrian/bicyclist thrown, run over, or with significant (20 mph) impact | Category C Trauma |
PIC - Motorcycle crash greater than 20 mph | Category C Trauma |
Age less than 5 or greater than 55 | Category D Trauma |
Patient with bleeding disorder or patient on anticoagulants | Category D Trauma |
Dialysis patient | Category D Trauma |
Pregnancy greater than 20 weeks | Category D Trauma |
EMS provider judgment | Category D Trauma |