GUIDELINES FOR TRAUMA DEFINITION

(Suggestions from Lake Superior RTAC)

October 2003

Definition of Major Trauma

Major Trauma includes the following categories:

1.      Physiologic Status

¨       Patients with multi-system blunt or penetrating trauma and unstable vital signs.

2.      Anatomical Injuries

¨       Patients with known or suspected anatomical injuries and stable or normal vital signs.

3.      Mechanism of Injury

¨       Patients who are involved in a “high energy” event with a risk for severe injury despite stable or normal vital signs.

Once these patients are identified, an appropriate systems response should be activated.  Triage occurs at both the pre-hospital and hospital level.

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                                         Activate Local Trauma Plan

Major Trauma – Adult

¨       Multi-system Blunt or Penetrating Trauma

with Unstable Vital Signs (Systolic BP<90,

HR>120, Resp<10 or >30, GCS<14, RTS<11)

¨       Penetrating injury of head, neck, torso, groin

¨       Burns > 15% TBSA (2^nd or 3^rd degree) or involving face, airway, hands, feet, or genitalia

¨       Amputation proximal to wrist or ankle

¨       Paralysis or other signs of spinal cord injury

¨       Flail chest

¨       Open or suspected depressed skull fracture

¨       Unstable pelvis or suspected pelvis fracture

¨       Two or more proximal long bone fractures suspected

¨       Distended, rigid abdomen with signs of shock

 

 

 

 

 

 

 

Major Trauma – Pediatric (<13 years)

¨       Multi-system Blunt or Penetrating Trauma

with Unstable Vital Signs:

v      Systolic BP – Neonate <60

                                  Infant (<2 yrs) <65

                                  Child (2-5 yrs) <70

                                  Child (6-12 yrs) <80

v      Respirations (all ages) <10 or >60

v      GCS < 14

v      PTS < 9

¨       Penetrating injury of head, neck, torso, groin

¨       Burns > 15% TBSA (2^nd or 3^rd degree) or involving face, airway, hands, feet, or genitalia

¨       Amputation proximal to wrist or ankle

¨       Paralysis or other signs of spinal cord injury

¨       Flail chest

¨       Open or suspected depressed skull fracture

¨       Unstable pelvis or suspected pelvis fracture

¨       Two or more proximal long bone fractures suspected

¨       Distended, rigid abdomen with signs of shock