Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 15 - Emergency Response Network
Chapter 191 - Trauma Protocols
Section I-19109 - Standard LERN Entry and Destination Criteria

Universal Citation: LA Admin Code I-19109

Current through Register Vol. 50, No. 9, September 20, 2024

A. On October 21, 2010, the Louisiana Emergency Response Network Board [R.S. 40:2842(1)] revised, adopted and promulgated "Standard LERN Entry Criteria" and "Standard Destination Protocol" for use in all regions, except region 7, of the Louisiana Emergency Response Network [R.S. 40:2842(3)], replacing the "LERN Entry Criteria" and "LERN Region 4 LCC Destination Protocol," adopted and promulgated June 18, 2009, as follows.

1. Standard LERN Entry Criteria-Pre -Hospital and Hospital Triage Protocol

Standard LERN Entry Criteria

Pre-Hospital and Hospital Triage Protocol

[] Unmanageable Airway

YES [RIGHTWARDS ARROW]

Call LCC

[] Tension Pneumothorax

[] Traumatic cardiac arrest

[] Burn patient without patent airway

[] Burn patient >40 percent 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) excluding isolated hip fractures from same level falls

[] 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:

>18 in. any site

* Ejection, partial or complete from automobile

* Death in same passenger compartment

[] Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 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

2. Standard Destination Protocol

Standard Destination Protocol

[] Unmanageable Airway

YES [RIGHTWARDS ARROW]

Closest ED

[] Tension Pneumothorax

[] Traumatic cardiac arrest

[] Burn patient without patent airway

[] Burn patient >40 percent BSA without IV

NO

[DOWNWARDS ARROW]

Neurologic Trauma

[] GCS <14

YES [RIGHTWARDS ARROW]

LERN

Level I

or II

[] 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)

NO

[DOWNWARDS ARROW]

Physiologic

[] SBP <90 (adults and >9 y/o)

YES [RIGHTWARDS ARROW]

LERN Level I, 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 I, 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) excluding isolated hip fractures from same level falls

[] Major joint dislocatio ns (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.)

Standard Destination Protocol

NO

[DOWNWARDS ARROW]

Mechanism

[] Falls >20 ft. (adults)

>10 ft. (child) or 2 to 3 times height

YES [RIGHTWARDS ARROW]

LERN Level II or III

[] High-risk auto crash

* Intrusion >12 in. occupant site:

* >18 in. any site

* Ejection, partial or complete from automobile

* Death in same passenger compartment

[] Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 MPH) impact

[] Motorcycle crash >20 MPH

NO

[DOWNWARDS ARROW]

Special

[] Pregnancy 20 weeks

YES [RIGHTWARDS ARROW]

LERN Level II or III

[] Burns (will follow ABA guidelines)

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

B. These protocols were published at LR 36:2743-2745 (November 20, 2010).

AUTHORITY NOTE: Promulgated in accordance with R.S. 9:2798.5 and R.S. 40:2846(A).

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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