Victorian State Trauma System Pre-hospital Major Trauma Triage

Does the trauma patient Y Yes have abnormal vital signs N Pre-hospital Vitals Signs meeting any of the VS criteria? N No Pre-hospital Vitals Signs Major Trauma Criteria Holloway Productions | Trauma VicMajor | Final Trauma Criteria

Y Age Term - 3 mths 4-12 mths 1-4 yrs 5-12 yrs 12+ yrs Adult HR <100 or >180 <100 or >180 <90 or >160 <80 or >140 <60 or >130 <60 or >120 Is the vital sign abnormality an isolated reduction in RR >60 >50 >40 >30 >30 <10 or >30 Transport to the GCS in a person > 65 years nearest Metropolitan BP sys <50 <60 <70 <80 <90 <90 of age who suffered a low fall Y Neurosurgical Facility Sp0 <90% <90% (< 1m) and who is located in 2 the metropolitan region? GCS <15 <13

Does the patient have specific N injuries meeting potential N major trauma criteria?

SpecificSpecific injuriesinjuries meeting meeting Y potentialpotential major major trauma trauma criteria criteria Does the patient have high Y risk criteria (mechanism and personal)? All penetrating injuries (except isolated superficial limb injuries) N Is the patient within Blunt injuries: Specific Injuries: 45 minutes transport time of a major trauma service? N Transport to the nearest • Serious injury to a single body • Limb amputation (or MNS for elderly head appropriate emergency region such that specialised care • Suspected Spinal Cord Injury injury patients above) care facility or intervention may be required, • Burns > 20% BSA or suspected or such that life, limb or long term respiratory tract burns quality of life may be at risk ROAD • Serious crush injury What is the transport mode? • Significant Injuries involving Y more than one body region • Major compound fracture or open dislocation HELICOPTER • Fracture to two or more Triage to the highest level of: femur, tibia, humerus of trauma service within • Fractured Pelvis Does the patient have 45 minutes transport time • Spinal Fracture signs of persisting N hypovolaemic shock despite initial resuscitation?

Y AV Clinician Notify ARV

Consult ARV coordinator MTS for discussion of initiation of High Risk Risk Criteria Criteria for for Major Major Trauma Trauma transfusion and of destination options including RTS

RTS • Ejection from vehicle AND: • Motor / cyclist impact > 30 kph • Age > 55 / Age < 16 • Fall from height > 3 m ARV ensures reception • OR Pregnant capability of RTS including • Struck on head by object falling > 3 m • OR Significant comorbidity Surgeon, OR, Blood Bank, • Explosion Supports. Notifies MTS • High speed MCA > 60 kph ARV follow up with receiving • Pedestrian impact primary hospital within 60 minutes regarding clinical • Prolonged extrication advice or potential need for Transport to a MTS transfer to MTS

Adult Retrieval Victoria 1300 36 86 61 PIPER 1300 13 76 50 Paediatric Infant Perinatal Emergency Retrieval Coordinators of Critical Care Services Version 1.0 | 22-10-2014