If you indicate that your patient suffers from trauma, Elite will prompt you for an answer in the “Trauma Center Criteria-Primary” box. If you click on the drop down box, you get a list of items. That same list appears on the left if you click on the bulleted list box. If you patient does not meet any trauma center criteria, you should click on the circle for “Not Applicable”.
The Trauma Center Criteria lists follow the CDC guidelines and TEMS protocols. They may not match directly to the trauma center alert criteria at the individual hospitals. There are always exceptions but if your patient meets any of the primary or secondary criteria, they probably should be transported to the closest trauma center. You can always select multiple ones if they all apply. Here are a few definitions and clarifications for some of the Primary criteria—
- Glascow Coma Score <14: The patient’s GCS should be less than 14. If you are documenting an assessed patient GCS of 15 in the vital signs, this does not apply.
- Two or more proximal long-bone fractures: This means two or more obvious or suspected femur or humerus fractures. Forearms and lower legs are considered distal.
- Amputation proximal to the wrist or ankle: This means that if the patient has an amputation at/above the wrist or ankle, they definitely meet criteria. Fingers would be distal to the wrist.
- Penetrating injuries to the head, neck, torso, and extremities proximal to the elbow or knee: This typically is targeted at shootings or stabbings in these areas because they can involve vital organs and major vessels.
- Pelvic fractures: Most “hip” fractures are really femur fractures. The pelvis is very difficult to fracture.
Please make your choices carefully. We have quite a few patients listed as BLS, going to SPAH with a GCS of 15 but crews are entering GCS<14 in this box. You want your report to be consistent and not contradictory.