Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 15 - Emergency Response Network
Chapter 191 - Trauma Protocols
Section I-19113 - LERN Entry Criteria: Trauma; LERN Destination Protocol: Trauma

Call LERN Communications Center for:

* Unmanageable Airway

* Tension Pneumothorax

* Traumatic cardiac arrest

* Burn Patient without patent airway

* Burn patient >40 percent BSA without IV

Physiologic

* GCS <14

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

<70 + 2 [age (yrs)] (age 1 to 8 y/o)

<70 (age 1 to 12 months)

<60 (term neonate)

* RR <10 or >29 (adults & >=9 y/o)

<15 or >30 (age 1 to 8 y/o)

<25 or >50 (<12 m/o)

Anatomic

* Open or depressed skull fractures

* Open head injury with or without CSF leak

* Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit)

* All penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee

* Flail Chest

* 2 or more proximal long-bone fractures

* Crush, degloved or mangled extremity

* Amputation proximal to wrist and ankle

* Pelvic Fractures

* 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

Call LERN Communications Center for:

Mechanism

* Falls >20 ft. adults

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

* Auto vs. pedestrian/bicyclist thrown, run over or significant

(>20 MPH) impact

* Motorcycle crash >20 MPH

* High-risk auto crash

* Intrusion >12 in, occupant site

>18 in. any site

* Ejection, partial or complete from automobile

* Death in same passenger compartment

Other

* Pregnancy >20 weeks

* Burns (follow ABA guidelines)

* Age >=55 y/o or <8 y/o

* Anticoagulation and bleeding disorders

* End stage renal disease

* Transplant patients

Multi/Mass Casualty Incident (MCI)

LERN Destination Protocol: Trauma

* Unmanageable Airway

YES [RIGHTWARDS ARROW]

Closest ED

* Tension Pneumothorax

* Traumatic cardiac arrest

* Burn patient without patent airway

* Burn patient >40 percent BSA without IV

Physiologic

* GCS < 14

YES [RIGHTWARDS ARROW]

LERN Level I, II, or III

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

<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

* Open or depressed skull fractures

YES [RIGHTWARDS ARROW]

LERN Level I, II, or III

* Open head injury with or without CSF leak

* Lateralizing signs or paralysis (i.e., one-sided weakness, motor, or sensory deficit)

* All penetrating injuries to neck, torso and extremities proximal to elbow and knee

* 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

LERN Destination Protocol: Trauma

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:

>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

Other

* Pregnancy >20 weeks

YES [RIGHTWARDS ARROW]

LERN Level II,

* Burns (follow ABA guidelines)

* Age >55 y/o or <8 y/o

* Anticoagulation and bleeding disorders

* End stage renal disease

* Transplant patients

MULTI/MASS CASUALTY INCIDENT (MCI)

YES [RIGHTWARDS ARROW]

LERN Level I, II, III, or IV