West Virginia Office of Emergency Medical Services

Protocol Changes

Posted: Monday, March 15, 2010 3:41 PM

At the recent Medical Policy and Care Committee (MPCC) meeting on February 26, 2010, one new protocol was developed and two others were modified that I wish to inform you about. These three polices will take effect April 1, 2010.

1. Field Trauma Triage Protocol 9103 is a new protocol that the MPCC was asked to develop at the recommendation of the State Trauma Advisory Council (STAC). Over many years, our medical commands have been appropriately directing ambulances with critically ill trauma patients to trauma centers. However, there has never been a specific formal protocol dealing with this. Protocol 9103 addresses this issue by specifying four categories of trauma patients:
   • Immediate Transport Criteria-those with immediate life-threatening conditions (lack of airway, etc.) that need to go, by air or ground, to the nearest facility capable of resuscitation regardless of trauma center designation status, or they will likely die.
   • Category A. Priority 1 Criteria-those meeting P1 criteria that need to go, by air or ground, to the highest level trauma center within 30 minutes transport.
   • Category B. Priority 2 (Anatomic) Criteria-those meeting the P2 anatomic criteria and also needing to go, by air or ground, to the highest level trauma center within 30 minutes transport.
   • Category C. Priority 2 (Mechanism) Criteria-those only meeting the P2 mechanism criteria and needing to go to the highest level trauma center within 30 minutes but whom usually don't need flown there. For aeromedical flight requests for this category, the Medical Command Physician must be involved in the decision. The transport of critically ill trauma patients to trauma centers saves lives; however, inappropriate flight requests for patients that do not need air transport exposes patients not only to risks, but also to huge expenses that are not necessary.
     
     Please note: The above P1 and P2 are Field Triage Criteria and may not exactly match a given hospital's P1 and P2 Trauma Page criteria.
2. Field Aeromedical Protocol 9105 has been revised to reflect those trauma patients meeting either the Immediate Transport Criteria, or Categories A, B, and (occasionally C) that should be considered for air medical transport if the ground transport time to a Level I or Level II Trauma Center is > 30 minutes, or if delays are expected due to extrication. This protocol specifies medical and environmental criteria for consideration of aeromedical evacuation-not that they require to be flown. The protocol also has new recommendations regarding night lighting of landing zones that reflects the use of night vision technology by some flight programs.
3. Medical Communications Protocol 9106 reflects changes that now require EMS personnel doing an inter-facility transport directly to an Emergency Department to contact Medical Command no less than 15 minutes prior to arrival at that facility. This hopefully will negate a problem that has arisen where EMS squads have arrived without warning to trauma centers with P1 or P2 trauma patients requiring a trauma page.

If you have any questions or need additional information, please feel free to contact Deron Wilkes by e-mail (deron.e.wilkes@wv.gov) or by telephone at 304-558-3956.

See attachment for protocol update details.

Related

• EMS Protocols (protocol updates incorporated)

File attachment

march_2010_protocol_update.pdf