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

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

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