GCS-3? BP 70/40? Well It's Been Fun Guys

 

I've got one foot out the door. We made it an entire shift without an MTP, nothing can stop me now. Good luck everyone else! Hurry and badge out of Kronos. You might be able to make it outside to see the helicopter land. 

(I'm kidding of course, we always stay to help the less fortunate -- 3rd shift)

What is the difference between a level 1 and a level 2 trauma code page anyway?

Upstate defines their traumas as level 1 if they meet the criteria:

Airway

• In need of emergent airway

• Intubated in the field

Breathing

• Ongoing respiratory compromise

• Respiratory arrest

Circulation

• SBP < 90

• Clinical Signs of Shock

Neurological

• GCS <=9

• Open skull fracture

Anatomic Diagnosis

• Penetrating trauma to head, neck, torso, groin or proximal to knee or elbow (unless obvious or

known superficial injury only)

• Partial or complete amputation of major limb (not isolated hand/finger injury)

Pregnant Trauma Patients

• >23 weeks (Fundus palpable at or above umbilicus) Meeting Level I or Level II criteria

Burns who also meet other Level I trauma criteria

May upgrade any level per ED Physician Discretion

A Level 2 trauma is paged following the criteria:

 Trauma Patients who meet any of the following and do not meet any Level I Criteria:

• Intubated inter-facility , otherwise stable, who also doesn’t meet any level 1 criteria

• Depressed skull fracture

• Fall from height (> 15 ft)

• Severe maxillofacial trauma

• Pedestrian struck – thrown, run over with significant impact (>20 mph)

• Motorcycle, ATV or snowmobile crash with severe injury

• Suspected or actual unstable pelvis without hypotension

• Blast injury

• Suspected or actual spinal cord injury

• Burns with greater than or equal to 20% total body surface area

• May upgrade any level per ED Physician Discretion

This information found here at Upstate. 

My hospital system includes sustained heart rate 120bpm and above as an automatic Level 1 trauma as well. 

As soon as we hear "GCS-3" or "agonal respirations" on the trauma line we start looking at each other like oh... maybe we should start getting ice and segments ready.