Page 50 - JSOM Summer 2023

SUPPLEMENTAL 1
TRAUMA CLASSIFICATION CRITERIA

Class 1 Trauma Team Activation: o Pediatric burn >15% BSA
o Signs of inhalation injury
Major trauma patient with life- or limb-threatening injury
• SBP at any time <90 and/or clinical evidence of shock (al-
tered level of consciousness [LOC], heart rate [HR] >120 Class II Trauma Activation:
with clinical signs of shock) Blunt or penetration injury to areas other than the Class I
• Age-specific hypotension and/or clinical evidence of activation criteria:
shock (altered LOC, decreased peripheral pulses, delayed • >65 years and currently taking an anticoagulant (not
cap refill) aspirin)
o 0–12 month SBP should be <70 • Amputation distal to the wrist or ankle
o 1–10 year SBP should be 70+ (age in years × 2) • Crush, degloving, or mangled extremity
o 10+ SBP should be <90 • Open long bone fracture
o Consider shock if blood products were given or if • Two or more distal bone fractures
≥40mL/kg crystalloid bolus administered to maintain • Pregnant woman with blunt abdominal trauma not
vital signs meeting other Class I criteria (does not include patients
• Child ≤2 years with cardiopulmonary resuscitation (CPR) with injuries isolated to the fetus)
in progress • Prolonged LOC
• Respiratory rate <10 or >29 • Altered mental status
• Penetrating injury to head, neck, torso, extremities proxi- • GCS 9–14
mal to elbow and knee (T-shirt/boxer shorts area) • Neurological deficit associated with spinal cord injury
• Flail chest, intubation at scene, airway compromise or (SCI) transferred from an outlying facility
obstruction, suspected tension/hemo/pneumothorax • Fall ≥20 feet
• Orthopedic injuries: o Pediatric fall ≥10 feet
o Two or more proximal long-bone fractures (femur/ • Motor vehicle crash (MVC), high speed >40 mph
humerus) o MVC >30 mph with unrestrained children <8 years
o Extremity trauma with loss of distal pulse • MCI (any incident with 5 or more patients) or other
o Amputation proximal to wrist or ankle ATV-like vehicle crash >20-mph
o Pelvic fracture (not to include hip fractures) • Burns, partial and full thickness, with or without associ-
• GCS ≤8 ated trauma, that do not meet other Class I criteria
• Open or depressed skull fracture o Pediatric burns <15% not meeting other class I criteria
• Paralysis or signs of spinal cord/cranial nerve injury • Resuscitated drowning victim
• Any hemorrhage control issue:
o Active or uncontrolled hemorrhage Trauma team activation upgrades should be considered for
o Bleeding controlled by a tourniquet the following co-morbidities in trauma patients ≥65 years
• Facility transfer with patient requiring blood or blood of age:
pressure support • Anticoagulant use and bleeding disorders
• Severe burn with or without associated trauma: • End-stage renal disease; patients requiring dialysis
o Partial or full thickness (2nd or 3rd degree) • Adults ≥65 years of age with SBP <110mmHg and/or
o Adult burn >20% body surface area (BSA) HR >90
o >50 years with >10% BSA

48 | JSOM Volume 23, Edition 2 / Summer 2023