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North Central Texas Trauma Regional Advisory Council
North Central Texas Trauma Regional Advisory Council
North Central Texas Trauma Regional Advisory Council
Yes
↓
Serious Airway
Compromise Yes → Transport to closest
facility capable of
managing airway
No
↓
BP less than 90mmHg
Or Yes → Continue to transport to Highest
Level Trauma Center ¹. If
Pulse>120/min
transport is greater than 15
Or
minutes - Transport to nearest
Other signs of shock
facility to provide stabilization
refractory to fluids
& transfer
No
↓
Transport to
appropriate Level 1 or
Level 2 Trauma
Center
Figure 1
North Central Texas Trauma Advisory Council
Trauma Triage Algorithm
Prehospital - Pediatric
Yes
↓
Serious airway or
respiratory compromise Yes → Transport to nearest
facility capable of
that cannot be managed?
managing
No airway/respiratory
compromise
↓
Hypotension present?
Neonate: <60 Yes → Transport to nearest facility¹
that can rapidly initiate blood
Infant (<2yr): <65
and provide initial
Child (2-5yr): <70
stabilization² and transfer out
Child (6-12yr): <80
to higher level of care.
No
↓
Transport to Pediatric
Trauma Center, if
within 15 minutes²
¹Nearest facility might include higher level of EMS agency or air evacuation landing site.
²If multiple levels of designation present within 15 minutes of each other, go to highest level facility. Level
I and II Trauma Centers should be considered equal.
Figure 2
North Central Texas Trauma Advisory Council
Trauma Triage Algorithm
Level III/IV Trauma Center
Level 1 Response
CMultisystem Blunt Trauma with Unstable Vital
Signs (BP<90, RTS<11, GSC<14)
CPenetrating Injury of head, neck, chest, abdomen
CBurns >20% TBSA (2nd or 3rd degree) or CInitiate Trauma Team Activation
involving face, airway, hands, feet, or genitalia CConsider early transport to Level I/II
CAmputations (with reimplantation potential) Trauma Center
CParalysis or other signs of spinal cord injury CCoordinate transport with Level I/II
CFlail chest Trauma Center
COpen or suspected depressed skull fracture
CUnstable pelvis or open pelvic fracture
Level 2 Response
CTwo or more longbone fractures
CSuspected pelvis fracture
CSignificant spinal column injury CInitiate Trauma Treatment Protocol
CInitiate Transfer Protocol to Level I/II
Center, if appropriate
Level 3 Response
High Energy Event, such as
CFall >20 ft
CEjection from vehicle
CDeath of occupant in same vehicle CPerform complete trauma evaluation
CRollover mechanism and appropriate serial examinations
CBent steering wheel
CAuto-pedestrian impact
CMotorcycle or bicycle involvement
CSignificant assault
9
CDeterioration in patient condition with
decrease in GCS, vital signs, or other
significant findings then initiate either
Trauma Team Activation or Trauma
Treatment Protocol
Figure 3
North Central Texas Trauma Advisory Council
Trauma Triage Algorithm
Level I/II Trauma Center
Level 1 Response
CMultisystem Blunt Trauma with Unstable Vital
Signs (BP<90, RTS<11, GSC<14)
CPenetrating Injury of head, neck, chest, abdomen
CBurns >20% TBSA (2nd or 3rd degree) or CInitiate Trauma Team Activation
involving face, airway, hands, feet, or genitalia
CAmputations (with reimplantation potential)
CParalysis or other signs of spinal cord injury
CFlail chest
COpen or suspected depressed skull fracture
CUnstable pelvis or open pelvic fracture
Level 2 Response
CTwo or more longbone fractures
CSuspected pelvis fracture
CSignificant spinal column injury CInitiate Trauma Treatment Protocol
Level 3 Response
High Energy Event, such as
CFall >20 ft
CEjection from vehicle
CDeath of occupant in same vehicle CPerform complete trauma evaluation
CRollover mechanism and appropriate serial examinations
CBent steering wheel
CAuto-pedestrian impact
CMotorcycle or bicycle involvement
CSignificant assault
9
CDeterioration in patient condition with
decrease in GCS, vital signs, or other
significant findings then initiate either
Trauma Team Activation or Trauma
Treatment Protocol
Figure 4