Policy 4–Trauma Criteria

What age range defines "Adult" for Trauma Code criteria?

Ages 15-69.

What age counts as "Geriatric" for Trauma Code criteria?

Age 70 and older.

What Airway findings meet Adult Level I trauma criteria?

In need of emergent airway, or intubated in the field.

What Breathing findings meet Adult Level I trauma criteria?

Ongoing respiratory compromise or respiratory arrest.

What Circulation findings meet Adult Level I trauma criteria?

SBP < 90, or clinical signs of shock.

What Neurological findings meet Adult Level I trauma criteria?

GCS <= 9, or open skull fracture.

What Anatomic findings meet Adult Level I trauma criteria?

Penetrating trauma to head, neck, torso, groin, or proximal to knee/elbow (unless clearly superficial); or partial/complete amputation of a major limb (not isolated hand/finger injury).

What Pregnancy finding meets Adult Level I trauma criteria?

Greater than 23 weeks gestation (fundus at or above umbilicus) meeting Level I or Level II criteria.

What Burn findings meet Adult Level I trauma criteria?

Any burn patient who also meets Level I criteria, or inhalation injury with an unsecured airway.

Who can upgrade a trauma level and under what condition?

The ED physician, at their discretion, may upgrade any trauma level.

How does the Circulation criterion differ for Geriatric (>70) Level I trauma vs Adult Level I?

Geriatric uses SBP < 100, while Adult uses SBP < 90.

What Mechanism criterion is unique to Geriatric Level I trauma (not listed for Adult)?

High-risk MVC — death of another occupant, or intrusion of 12 inches into the passenger compartment.

What is required for a patient to qualify for Level II trauma criteria?

They meet one of the Level II criteria and do NOT meet any Level I criteria.

Name Level II trauma criteria related to skull/head injury.

Depressed skull fracture, or severe maxillofacial trauma.

Name Level II trauma criteria related to falls or being struck.

Fall from height greater than 15 ft, or pedestrian struck/thrown/run over with significant impact (>20 mph).

Name Level II trauma criteria related to vehicle crashes.

Motorcycle, ATV, or snowmobile crash with severe injury.

Name Level II trauma criteria related to pelvis and spine.

Suspected or actual unstable pelvis without hypotension, or suspected/actual spinal cord injury.

Name Level II trauma criteria related to burns and inhalation.

Burns with >= 20% TBSA, or inhalation injury with a secure airway.

Name two other Level II trauma criteria.

Blast injury, and crush injuries (also: intubated inter-facility but otherwise stable and not meeting Level I criteria).