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Trauma Decision Tree

Trauma Decision Tree Maryland Medical Protocols for EMS Providers July 1, 2010

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
Created by: David645



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