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.
