Ohio Admin. Code 4765-14-02 - Determination of a trauma victim
Emergency medical service personnel shall use the criteria in this rule, consistent with their certification, to evaluate whether an injured person qualifies as an adult trauma victim, geriatric trauma victim, or pediatric trauma victim, in conjunction with the definition of trauma in section 4765.01 of the Revised Code and this chapter.
(A) An adult trauma victim is a person
between the ages of sixteen and sixty-nine years of age inclusive exhibiting
one or more of the following physiologic conditions, anatomic conditions, or
cause of injury indicators:
(1) Physiologic
conditions:
(a) Glasgow coma scale less than
or equal to thirteen;
(b) Loss of
consciousness greater than five minutes;
(c) Deterioration in level of consciousness
at the scene or during transport;
(d) Failure to localize to pain;
(e) Respiratory rate less than ten or greater
than twenty-nine;
(f) Need for
ventilatory support;
(g) Requires
relief of tension pneumothorax;
(h)
Pulse greater than one hundred twenty in combination with evidence of
hemorrhagic shock;
(i) Systolic
blood pressure less than ninety, or absent radial pulse with carotid pulse
present;
(2) Anatomic
conditions:
(a) Penetrating trauma to the
head, neck, or torso;
(b)
Significant, penetrating trauma to extremities proximal to the knee or elbow
with evidence of neurovascular compromise;
(c) Injuries to the head, neck, or torso
where the following physical findings are present:
(i) Visible crush injury;
(ii) Abdominal tenderness, distention, or
seatbelt sign;
(iii) Pelvic
fracture;
(iv) Flail
chest;
(d) Injuries to
the extremities where the following physical findings are present:
(i) Amputations proximal to the wrist or
ankle;
(ii) Visible crush
injury;
(iii) Fractures of two or
more proximal long bones;
(iv)
Evidence of neurovascular compromise;
(e) Signs or symptoms of spinal cord
injury;
(f) Second degree or third
degree burns greater than ten per cent total body surface area, or other
significant burns involving the face, feet, hands, genitalia, or
airway;
(g) Open skull
fracture;
(3) Cause of
injury indicator provided by vehicle telemetry data consistent with a high risk
for injury;
(4)
On scene fatality in same vehicle.
(B) A pediatric trauma victim is a
person under sixteen years of age exhibiting one or more of the following
physiologic conditions, anatomic conditions, or cause of injury indicators:
(1) Physiologic conditions:
(a) Glasgow coma scale less than or equal to
thirteen;
(b) Loss of consciousness
greater than five minutes;
(c)
Deterioration in level of consciousness at the scene or during
transport;
(d) Failure to localize
to pain;
(e) Evidence of poor
perfusion, or evidence of respiratory distress or failure;
(f) Respiratory rate less than twenty for
infants less than one year old;
(2) Anatomic conditions:
(a) Penetrating trauma to the head, neck, or
torso;
(b) Significant, penetrating
trauma to extremities proximal to the knee or elbow with evidence of
neurovascular compromise;
(c)
Injuries to the head, neck, or torso where the following physical findings are
present:
(i) Visible crush injury;
(ii) Abdominal tenderness, distention, or
seatbelt sign;
(iii) Pelvic
fracture;
(iv) Flail
chest;
(d) Injuries to
the extremities where the following physical findings are present:
(i) Amputations proximal to the wrist or
ankle;
(ii) Visible crush
injury;
(iii) Fractures of two or
more proximal long bones;
(iv)
Evidence of neurovascular compromise;
(e) Signs or symptoms of spinal cord
injury;
(f) Second or third degree
burns greater than ten per cent total body surface area, or other significant
burns involving the face, feet, hands, genitalia, or airway;
(g) Open skull fracture;
(3) Cause of injury indicator provided by
vehicle telemetry data consistent with a high risk for injury;
(4)
On scene fatality
in same vehicle.
(C) A geriatric trauma victim is a person
seventy years of age or older exhibiting one or more of the following causes of
injury or physiologic conditions, anatomic conditions, or cause of injury
indicators:
(1) Physiologic conditions:
(a) Glasgow coma scale less than or equal to
fourteen in a trauma patient with a known or suspected traumatic brain
injury;
(b) Glasgow coma score less
than or equal to thirteen;
(c) Loss
of consciousness greater than five minutes;
(d) Deterioration in level of consciousness
at the scene or during transport;
(e) Failure to localize to pain;
(f) Respiratory rate less than ten or greater
than twenty-nine;
(g) Need for
ventilatory support;
(h) Requires
relief of tension pneumothorax;
(i)
Pulse greater than one hundred twenty in combination with evidence of
hemorrhagic shock;
(j) Systolic
blood pressure less than one-hundred, or absent radial pulse with carotid pulse
present;
(2) Anatomic
conditions:
(a) Penetrating trauma to the
head, neck, or torso;
(b)
Significant, penetrating trauma to extremities proximal to the knee or elbow
with evidence of neurovascular compromise;
(c) Injuries to the head, neck, or torso
where the following physical findings are present:
(i) Visible crush injury;
(ii) Abdominal tenderness, distention, or
seatbelt sign;
(iii) Pelvic
fracture;
(iv) Flail
chest;
(d) Injuries to
the extremities where the following physical findings are present:
(i) Amputations proximal to the wrist or
ankle;
(ii) Visible crush
injury;
(iii) Fracture of one
proximal long bone sustained as a result of a motor vehicle crash;
(iv) Fractures of two or more proximal long
bones;
(v) Evidence of
neurovascular compromise;
(e) Signs or symptoms of spinal cord
injury;
(f) Second degree or third
degree burns greater than ten per cent total body surface area, or other
significant burns involving the face, feet, hands, genitalia, or
airway;
(g) Injury sustained in two
or more body regions;
(h) Open
skull fracture;
(3)
Cause of injury indicators:
(a) Pedestrian
struck by a motor vehicle;
(b) Fall
from any height, including standing falls, with evidence of a traumatic brain
injury;
(c) Vehicle telemetry data
consistent with a high risk for injury;
(4)
On scene fatality
in same vehicle.
(D) Emergency medical service personnel shall
also consider mechanism of injury and special considerations, as taught in the
EMT, advanced EMT or paramedic curriculum, when evaluating whether an injured
person qualifies as a trauma victim, including but not
limited to current use of anticoagulant or anti-platelet
medications .
Notes
Promulgated Under: 119.03
Statutory Authority: 4765.11, 4765.40
Rule Amplifies: 4765.40
Prior Effective Dates: 10/28/2002, 12/29/2008, 12/12/2014, 06/01/2018
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