Current through Register Vol. 50, No. 9, September 20, 2024
A. On November 15, 2007, the Louisiana
Emergency Response Network Board [R.S.
40:2842(1)] adopted and
promulgated "Region 7 LERN Entry and Destination Protocol" for region 7 of the
Louisiana Emergency Response Network [R.S.
40:2842(3)], which region
includes the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto,
Natchitoches, Red River, Sabine and Webster, as follows.
1.
a.
Traumatic patients who meet the following criteria will be entered to LERN call
center and should be transported directly to LSUHSC in Shreveport, Louisiana,
if possible:
i. airway compromise (intubated,
apneic, or obstructed airway);
ii.
penetrating wound of head, neck, chest, abdomen, groin, or buttocks;
iii. blood pressure <=100 or signs of
shock;
iv. GCS 12 or
less;
v. new onset neurological
deficit associated with traumatic event;
vi. extremity wound with absent pulse or
amputation proximal to foot or hand.
b. Trauma patients who meet the following
criteria, and are located outside the city limits of Shreveport and Bossier
City, should be taken to nearest hospital for immediate stabilization followed
by continued rapid transport to LSUHSC Shreveport per the LERN hospital
protocol:
i. unable to establish and maintain
adequate airway/ventilation;
ii.
hypotension unresponsive to crystalloids (no more than 2 L);
iii. patients who meet trauma center criteria
but have a transport time 60 minutes;
iv. traumatic arrest.
B. On May 8,
2008, the Louisiana Emergency Response Network Board (R.S.
40:2842(1)) amended and
promulgated, as amended, "Region 7 LERN Entry and Destination Protocol" for
region 7 of the Louisiana Emergency Response Network (R.S.
40:2842(3)), which region
includes the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto,
Natchitoches, Red River, Sabine and Webster, which protocol was originally
adopted and promulgated on November 15, 2007, so that the "Region 7 Louisiana
Emergency Response Network Entry and Destination Protocol," as amended,
effective May 8, 2008, is as follows.
1.
a. Traumatic patients who meet the following
criteria will be entered to LERN call center and should be transported directly
to LSUHSC in Shreveport, if possible:
i.
airway compromise (intubated, apneic, or obstructed airway);
ii. penetrating wound of head, neck, chest,
abdomen, groin, or buttocks;
iii.
blood pressure <=100 or signs of shock;
iv. GCS 12 or less;
v. new onset neurological deficit associated
with traumatic event;
vi. extremity
wound with absent pulse or amputation proximal to foot or hand;
vii. burn patients as identified following
ABA guidelines;
viii.
healthcare provider discretion-patients evaluated by hospitals
may be entered into LERN if the evaluating hospitals medical personnel
determines the patient has a medical condition requiring immediate surgical
evaluation and/or intervention and the transferring hospital does not have
these services immediately available at that facility (Healthcare
provider discretion does not include orthopedic injuries.).
b. Patients that have
been entered into LERN but will require greater than 60 minute transport time
from the field should stop at local area hospitals for stabilization. These
patients should still be entered into LERN from the field but will require
transport to local area hospitals for stabilization. LERN will facilitate the
movement of these patients from the local hospital once stabilizing measures
are completed.
i. The following are
conditions requiring immediate stabilization by local area hospitals:
(a). unable to establish and maintain
adequate airway/ventilation;
(b).
hypotension unresponsive to crystalloids (no more than 2 L);
(c). patients who meet trauma center criteria
but have a transport time >60 minutes;
(d). traumatic arrest.
C. The
following will be routed directly to the LSUHSC Burn Unit from local area
hospitals or from the field:
1.
partial-thickness and full thickness burns greater than 10 percent of the total
body surface area (TBSA) in patients younger than 10 years of age or older than
50 years of age;
2.
partial-thickness and full thickness burns greater than 20 percent of the total
body surface area (TBSA) in other age groups;
3. partial-thickness and full thickness burns
involving the face, eyes, ears, hands, feet, genitalia, perineum, or skin
overlying major joints;
4.
full-thickness burns greater than 5 percent TBSA in any age group;
5. electrical burns, including lightning
injury;
6. chemical
burns;
7. patients with inhalation
injury;
8. burn injury in patients
with pre-existing illnesses that could complicate management, prolong recovery,
or adversely affect mortality risk;
9. any burn patient in whom concomitant
trauma poses an increased risk of morbidity or mortality may be treated
initially in a trauma center until stable before transfer to a burn
center;
10. children with burns
seen in hospitals without qualified personnel or equipment for their
care;
11. burn injury in patients
who will require special social and emotional or long-term rehabilitative
support, including cases involving suspected child abuse or neglect.
D. These protocols were published
at LR 35:1183-1184 (June 20, 2009).
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
9:2798.5 and
R.S.
40:2846(A).
