EMS Policy Manual - Contra Costa Health Services

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Contra Costa Emergency Medical Services POLICY #: 13 PAGE: 5 of 5 C. Contra Costa County Trauma Center Bypass: 1. Transport patients who meet high-risk criteria or patients directed to a trauma center by base hospital destination decision via ground or air transport, as indicated, to the closest appropriate and available designated out-of-county trauma center. 2. If an out-of-county trauma center is not available: a. Transport via ground to the nearest Basic ED, which may include John Muir Medical Center – Walnut Creek Campus. b. If helicopter transport is utilized, transport to John Muir Medical Center – Walnut Creek Campus. D. Out-of-County Destinations: 1. Aside from trauma center bypass situations, an out-of-county destination may be the appropriate destination if there is significant time saving. 2. The base shall be contacted to assist with destination determination of patients who require transport to out-of-county destinations, including pediatric patients with prolonged transport times (>30 minutes) and patients redirected because of trauma center bypass. 3. The base will be responsible for notification of other trauma centers to alert them of the patient’s pending arrival. E. Disrupted Communications with Base: 1. Patients who normally require base hospital destination determination should be transported to the most appropriate and available receiving facility per the field personnel’s judgment. 2. Alternate mechanisms of communication (e.g., via dispatch) should be used to determine trauma center availability if out-of-county destinations are being considered.
Contra Costa Emergency Medical Services EMERGENCY RE-TRIAGE AND TRANSFERS TO TRAUMA CENTERS POLICY #: 14 PAGE: 1 of 4 EFFECTIVE: 1/13 REVIEWED: 12/12 I. PURPOSE To outline the criteria and process for emergency re-triage and for transfer of patients needing trauma care from non-trauma facilities to appropriate trauma centers. II. POLICY Under field trauma triage protocols, most critical trauma patients will be triaged directly to a Trauma Center from the field. Trauma patients who present at other facilities via EMS or other arrival mode, when medically appropriate, should be considered for re-triage or transfer to trauma centers for definitive care. III. DEFINITIONS A. Emergency Trauma Re-triage: The movement of patients meeting specific high-acuity criteria to trauma center for trauma care. Timeliness of evaluation and intervention at the trauma center is critical. B. Trauma Transfer: The movement of other patients with traumatic injuries to the trauma center (those not meeting Emergency Trauma Re-Triage criteria) whose needs may be addressed in a prompt fashion but are less likely to require immediate intervention. IV. EMERGENCY TRAUMA RE-TRIAGE PATIENT SELECTION A. Adult Patients (Age 15 and Over) appropriate for Emergency Trauma Re-Triage to the trauma center** include: 1. Patients with abnormal blood pressure/perfusion as evidenced by: a. Systolic blood pressure under 90 b. Need for high-volume fluid resuscitation (> 2 L NS) or immediate blood replacement 2. Patients with significant neurological findings or injuries, including a. GCS less than 9 or deteriorating by 2 or more during observation b. Blown pupil c. Obvious open skull fracture 3. Patients meeting anatomic criteria: a. Penetrating injury to head, neck, chest, or abdomen b. Extremity injury with ischemia evident or loss of pulses 4. Patients, who in the judgment of the evaluating emergency physician, are anticipated to have a high likelihood for emergent life- or limb-saving surgery or other intervention within two (2) hours. ** Note: John Muir Health - Walnut Creek, Alameda County Medical Center (Highland), and Eden Medical Center all utilize these re-triage criteria. Criteria may vary at other centers.
Page 1 and 2: Contra Costa County Emergency Medic
Page 3 and 4: EMS Policies # 1 - EMT-1 Certificat
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EMS Policy Manual - Contra Costa Health Services

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