EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.
Issue link: https://emsworld.epubxp.com/i/35512
TRAUMA TRIAGE GUIDELINES • Speed >40 mph, deformity >20 inches, rollovers, and prolonged extrication time were all removed because of a lack of evidence supporting the need to transport these patients to a trauma center. “These guidelines should help prevent undertriage.” • The last step, special consider- ations, added time-sensitive extremity injury, end-stage renal disease requiring dialysis and EMS provider judgment. • Pregnancy was added at >20 weeks, and patients with cardiac disease, respiratory disease, diabetes, cirrhosis, obesity or immunosuppression were removed due to a lack of evidence. Patient Transport and Outcome Looking at all of the factors, including the patient’s age (67), the possibility of internal abdominal injuries due to blunt trauma, the fact that the vehicle was trav- eling at an unknown speed, the danger- ously high blood pressure, the history of previous acute myocardial infarction and personal opinion, we diverted from a local hospital and transported to the closest level 1 trauma center. After trauma assessment at the hospital, CT scans were all negative. The patient had an extracranial hema- toma and was admitted for observation for the night. Luckily, she did not have any serious consequences related to the motor vehicle accident and was discharged home the following day. While she had a good outcome and no serious injuries, according to the CDC guidelines, she qualifi ed to be transported to a trauma center. While maintaining an acceptable level of overtriage, these guidelines should help prevent under- triage, a situation that can result in high morbidity and mortality for patients who are not transported to facilities capable of managing their serious injuries. BIBLIOGRAPHY Centers for Disease Control and Prevention Guidelines for Field Triage of Injured Patients–Recommendations of the National Expert Panel on Field Triage. MMWR 58:RR- 1:1–35, 2009. Joshua Bucher, BA, EMT-B, is a member of the Morganville First Aid & Rescue Squad in Marlboro, NJ, and a third-year medical student at Jefferson Medical College. EMS PRODUCT NEWS HALO XL Trauma Dressing PMI’s Halo XL Trauma Dressing is a highly aggressive, oversized, transparent occlusive dressing designed primarily to cover larger blast wounds. The XL is an excellent occlusive dressing for large abdominal wounds, peppering chest wounds associated with IED blast injuries and secondary blast injuries (SBIs). The patented hydro-gel provides superior adhesion to the wound area even when moisture, fluids or blood are present. Visit www.progressivemed.com. Circle 49 on Reader Service Card Electronic Access Control Lock The CompX eLock from CompX Security Products offers a wireless (802.11g) or Ethernet capable electronic access control lock for existing or new cabinet installations. The network function enables two-way communication, via common encryption methods, between any eLock and any computer on an existing network through LockView software. The CompX eLock and LockView provide many features such as a comprehensive audit trail of the last 15,000 access attempts, including date, time and user name. Visit http://compxelock.com for all eLock solutions. Circle 50 on Reader Service Card 58 JULY 2011 | EMSWORLD.com Life/form CRiSis Manikins The CRiSis Manikins from Nasco are complete resuscitation systems with five stations allowing you to practice different senarios. Each manikin consists of a full body CPR manikin, IV arm, blood pressure arm, defibrillation chest skin, and features the Airway Larry airway management head. Ideal for ACLS, paramedic, EMT, and nursing training at every level. Call 800/558-9595 or visit www.eNasco.com/ healthcare. Circle 51 on Reader Service Card