Time Critical Guidelines: Trauma (Adult)
                     
In Setting of Trauma
                  
Are VS's abnormal?                  
                     
Assess Vital Signs No
Vital Signs are normal...
           
Are there any of the following?
GCS:
 <13
Heart Rate:
 >124
Resp Rate:
<12 or >24
BP:
 <90 mmHg
SPO2:
 <90%
  ...but is there a Pattern of Injury?            
                 
  Assess for Pattern of Injury No
No Pattern of Injury...
      
  Are there any of the following:

Penetrating Injuries
- Head / Neck / Chest / Abdomen / Pelvis / Axilla / Groin

Blunt Injuries
- Significant injury to a single region:
Head / Chest / Abdomen / Axilla / Groin
- Injuries involving two or more of the above body regions

Specific Injuries
- Limb amputations / limb threatening injuries
- Suspected spinal cord injury
- Burns >20% or involving respiratory tract
- Serious crush injury
- Major compound fracture or open dislocation
- Fractured pelvis
- Fracture to two or more of the following: Femur / Tibia / Humerus		   ...and Vital Signs are normal, but is there a Mechanism of Injury?      
  Yes              
        Assess for Mechanism of Injury No
No MOI
        • Are there any of the following:

- Ejection from vehicle
- Motor/cyclist impact >30kph
- Fall from height >3m
- Struck on head by falling object >3m
- Explosion
- High speed MCA >60kph
- Pedestrian impact
- Prolonged extrication >30min		   • Vital Signs are normal
• No Pattern of Injury
          Action
          • Triage to nearest appropriate facility if required
             
         
Not Time Critical
          Yes    
        Are there also any Co-morbidities? No    
        Yes   Any of the following:

- Age >55
- Pregnancy
- Significant underlying medical condition		      
              Yes      
Major Trauma   Significant Pattern of Injury   Positive MOI WITH Co-morbidities   Positive MOI but NO Co-morbidities
• Vital Signs NOT normal   • Vital Signs normal   • Vital Signs are normal
• No Pattern of Injury		   • Vital Signs are normal
• No Pattern of Injury
                     
Actually Time Critical
Emergent Time Critical
 
Potential Time Critical
 
Potential Time Critical
                     
Action at per appropriate CPG   Action at per appropriate CPG   Action at per appropriate CPG   Action at per appropriate CPG
Consider MICA / Aeromedical support   Consider MICA / Aeromedical support   Triage to highest level of trauma service within 30min   Triage to nearest appropriate facility with notification
Triage to highest level of trauma service within 30min   Triage to highest level of trauma service within 30min