Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 15 - Emergency Response Network
Chapter 191 - Trauma Protocols
Section I-19117 - LERN Destination Protocol: Trauma
Current through Register Vol. 50, No. 9, September 20, 2024
A. On November 21, 2013, 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 26, 2012, and repealing "LERN ENTRY CRITERIA, Trauma Pre -Hospital and Hospital Triage Protocol" adopted and promulgated April 21, 2011, as follows.
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* Unmanageable airway |
[RIGHTWARDS ARROW] |
Closest ED/Trauma Center |
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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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NO [DOWNWARDS ARROW] |
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Physiologic |
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* GCS < 14 |
[RIGHTWARDS ARROW] |
To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center |
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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 & >=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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NO [DOWNWARDS ARROW] |
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Anatomic |
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* Open or depressed skull fractures |
[RIGHTWARDS ARROW] |
To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center |
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* Open head injury with or without CSF leak |
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* Lateralizing signs or paralysis (i.e., onesided weakness, motor, or sensory deficit) |
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* All penetrating injuries to head, neck, torso, and extremities proximal to elbow and 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 and 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 |
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(decreased peripheral pulses or prolonged capillary refill, motor or sensory deficits distal to fracture) |
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NO [DOWNWARDS ARROW] |
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Mechanism |
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* Falls >20 ft. adults |
[RIGHTWARDS ARROW] |
To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center |
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>10 ft. (child) or 2 to 3 times height |
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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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NO [DOWNWARDS ARROW] |
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Other |
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* Pregnancy >20 weeks |
[RIGHTWARDS ARROW] |
To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center |
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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] |
To Appropriate Trauma Center or Hospital as Determined by LERN Communication Center |
B. This protocol was published at LR 40:190-191 (January 20, 2014).
AUTHORITY NOTE: Promulgated in accordance with R.S. 9:2798.5 and R.S. 40:2846(A).
