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 or anatomic conditions:

(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) Requires endotracheal intubation;

(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.

(B) A pediatric trauma victim is a person under sixteen years of age exhibiting one or more of the following physiologic or anatomic conditions:

(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.

(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.

(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 or anatomic conditions:

(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) Requires endotracheal intubation;

(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.

(3) Cause of injury:

(a) Pedestrian struck by a motor vehicle;

(b) Fall from any height, including standing falls, with evidence of a traumatic brain injury.

(D) Emergency medical service personnel shall also consider mechanism of injury and special considerations, as taught in the EMT-basic, EMT-intermediate, or EMT-paramedic curriculum, when evaluating whether an injured person qualifies as a trauma victim.

R.C. 119.032 review dates: 09/14/2011 and 09/14/2014
Promulgated Under: 119.03
Statutory Authority: RC 4765.11 , RC 4765.40
Rule Amplifies: RC 4765.40
Prior Effective Dates: 10/28/02, 12/29/08