New Mexico Administrative Code
Title 7 - HEALTH
Chapter 27 - EMERGENCY MEDICAL SERVICES
Part 7 - TRAUMA CARE SYSTEM
Section 7.27.7.12 - APPENDIX A TRAUMA PATIENT TRIAGE CRITERIA GUIDELINES
Universal Citation: 7 NM Admin Code 7.27.7.12
Current through Register Vol. 35, No. 18, September 24, 2024
A. Trauma Patient Triage Criteria Guidelines. The following guidelines were developed by the TAC standards committee and presented to the TAC for review in January 2001. It was subsequently brought before the JOE (Joint Organization on EMS Education) and the EMS Medical Direction Committee for discussion.
(1) purpose: To present for consideration by
the TAC a standardized framework of Statewide Prehospital Trauma Triage
Guidelines for use by all levels of EMS providers using clear text
communications. This criteria does not affect the ability of a local area to
further define specific triage criteria. Rather it establishes a common
language for EMS to communicate regarding patient condition. It is not meant to
replace local area triage, treatment and transport guidelines.
(2) history: In the early 1990's EMS training
programs adopted the definitions of critical patients as defined by University
Hospital, function as the only Level I Trauma Center in the state. Level I, II
and III criteria for trauma patients were subsequently taught to all New Mexico
EMS providers. As local triage criteria changed and was further defined, the
changes were not reflected in EMS training statewide.
(3) goal of this guideline:
(a) create a statewide minimum trauma triage
criteria guideline for all EMS personnel.
(b) assist regional trauma centers with
educating EMS personnel to better understand trauma patient triage
criteria.
(c) use as a tool by
non-designated facilities to better understand trauma patient triage
criteria.
(d) adopt (and further
clarify as appropriate) within area existing trauma plan(s) in conjunction with
ReTrAC's.
(4) approval
will require review and approval by the ReTrAC's, Statewide Trauma Advisory
Committee, EMS Medical Direction Committee and the Joint Organization on EMS
Education (JOE).
(5)
impact:redefining of learning objectives, scenarios, test questions and
educational related information for all levels of EMS providers. Current EMS
providers will be taught the revised criteria during the 2001-2002 EMS
refresher cycles. New EMS providers will begin to be taught the revised
criteria effective July 2001.
(6)
target implementation date: July 1, 2002.
(7) patient status: based on information
obtained by physical examination and history, patients are classified according
to stability as follows:
(a) stable - patient
is stable, with no apparent risk of developing a life threatening or disabling
condition. Non-emergent transport is appropriate.
(b) serious - patient is at moderate risk of
developing a life threatening or disabling condition. Most circumstances will
merit non-emergent transport.
(c)
Critical - Patient has a severe & acute life threatening or disabling
condition. Immediate intervention is required. Emergency transport at EMS
providers' discretion. Examples include penetrating and/or blunt trauma
injuries to chest and/or abdominopelvic cavity with unstable vitals, or if
patient presents with vitals indicating they are likely to
deteriorate
(8)
transport destination decisions
(a) stable
status patients will be transported to the nearest appropriate facility of the
patient's choice only when that destination does not compromise the patient and
the destination location does not result in the transport vehicle moving
outside of the established EMS response area. If the patient is a minor,
incapable of making an informed decision, incarcerated, or subject to the
guardianship of another, Medical Control will be contacted when the decision of
the responsible party, is not, in the EMS provider's opinion, in the best
interest of the patient.
(b)
serious status patients will be transported to the closest appropriate facility
within the transporting vehicle's service area. The destination decision
process will fall on the EMS providers and in some cases Medical
Control.
(c) critical status
patients will be transported to the most readily accessible facility that is
staffed and equipped to provide initial stabilization care upon arrival. The
destination decision process will fall on the EMS providers and in some cases
Medical Control.
B. Institutional Trauma Team Activation Criteria
(1) pre-hospital
guidelines for requesting trauma team activation.
(a) systolic BP 90 mm Hg with clear evidence
of hemodynamic instability
(b)
decreased level of consciousness secondary to trauma (GCS 10)
(c) all non-superficial penetrating injuries
to head, neck or torso
(d) evidence
of airway compromise not manageable in the field
(e) significant respiratory compromise of
traumatic origin
(f) suspected
pelvic fracture with hemodynamic instability
(g) burns 10% of body surface, or burns
involving face and/or airway
Special considerations should be given for all patients 5 or 65 years of age, pregnancy greater than 20 weeks, or other related co-morbid factors (Coumadin, Beta Blockers, etc.)
(2) EMS notification of significant MOI:
Mechanism of Injury (MOI) should be a consideration for adoption in each area
trauma activation criteria. It is recognized that the inclusion of MOI has
different advantages and disadvantages for urban and rural communities. As a
minimum, EMS should report all incidents involving high evidence of significant
MOI:
(a) falls greater than two times the
patient height
(b) incidents
involving rapid deceleration
(c)
passenger space vehicle intrusion greater than twenty inches.
(d) death of another occupant from same
vehicle.
(e) vehicle
ejection
(f) high speed
rollover
Disclaimer: These regulations may not be the most recent version. New Mexico 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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
