Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 15 - Emergency Response Network
Chapter 191 - Trauma Protocols
Section I-19115 - LERN Destination Protocol: TRAUMA
Current through Register Vol. 50, No. 9, September 20, 2024
A. On April 26, 2012, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and (3)] adopted and promulgated "LERN Destination Protocol: Trauma" replacing the "LERN Destination Protocol: Trauma" adopted and promulgated April 21, 2011, as follows.
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* Unmanageable Airway |
[RIGHTWARDS ARROW] |
Closest ED |
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* Tension Pneumothorax |
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* Traumatic cardiac arrest |
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* Burn Patient without patent airway |
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* Burn patient >40 percent BSA without IV |
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Physiologic |
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* GCS <14 |
[RIGHTWARDS ARROW] |
Level I, II, or III* |
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* SBP <90 (adults and >9 y/o) |
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<70 + 2 [age (yrs)] (age 1 to 8 y/o) |
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<70 (age 1 to 12 months) |
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<60 (term neonate) |
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* RR <10 or >29 (adults and=9 y/o) |
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<15 or >30 (age 1 to 8 y/o) |
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<25 or >50 (<12 m/o) |
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Anatomic |
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* Open or depressed skull fractures |
[RIGHTWARDS ARROW] |
Level I, II, or III* |
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* Open head injury with or without CSF leak |
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* Lateralizing signs or paralysis (i.e., one -sided weakness, motor, or sensory deficit) |
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* All penetrating injuries to head, neck, torso, & extremities proximal to elbow & knee |
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* Flail Chest |
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* 2 or more proximal long-bone fractures |
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* Crush, degloved or mangled extremity |
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* Amputation proximal to wrist & ankle |
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* Pelvic Fractures |
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* Hip Fractures (hip tenderness, deformity, lateral deviation of foot) excluding isolated hip fractures from same level falls |
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* Major joint dislocations (hip, knee, ankle, elbow) |
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* Open Fractures |
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* Fractures with neurovascular compromise (decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture) |
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Mechanism |
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* Falls >20 ft. adults >10 ft. (child) or 2 to 3 times height |
[RIGHTWARDS ARROW] |
Level I, II, or III* |
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* High -risk auto crash |
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* Intrusion >12 in. occupant site |
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>18 in. any site |
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* Ejection, partial or complete from automobile |
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* Death in same passenger compartment |
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* Auto vs. pedestrian/bicyclist thrown, run over or significant (>20 MPH) impact |
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* Motorcycle crash >20 MPH |
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Other |
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* Pregnancy >20 weeks |
[RIGHTWARDS ARROW] |
Level II, or III* |
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* Burns (follow ABA guidelines) |
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* Age >=55 y/o or <8 y/o |
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* Anticoagulation and bleeding disorders -patients w/ head injuries are at high risk for rapid deterioration |
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MULTI/MASS CASUALTY INCIDENT (MCI) |
[RIGHTWARDS ARROW] |
Level I, II, or III* |
*Refers to ACS Verified Level Trauma Center Where trauma center not available, patient will be routed to facility with appropriate resource which may not need be the highest level facility.
B. This protocol was published at LR 38:1462-1463 (June 20, 2012).
AUTHORITY NOTE: Promulgated in accordance with R.S. 9:2798.5 and R.S. 40:2846(A).
