Trauma Intervention Prediction

Site

Froedtert North Memorial KSMC Ohio Health NJMS UK Healthcare UT Health Houston UF Health Patras

Level of Care

ALS BLS

Patient Type

Transfer Scene

Transfer Method

Ground Helicopter Other

Estimated Time to Arrival (min)

Please record most aberrant vitals below:

Systolic Blood Pressure

Pulse

GCS Score

Temperature (F)

Age

Gender

Male Female Nonbinary

Race

White Hispanic or Latino Asian Black or African American Native Hawaiian or Other Pacific Islander Amercan Indian or Alaska Native Indian Arab N/A

Bariatric

Yes No

Mechanism of Injury

Stab Gunshot Fall Motor Vehicle Motorcycle Bicycle Pedestrian Struck Other

Open Fracture

Yes No

Central Gunshot Wound

Yes No

Field Assisted Ventilation

Intubated Supraglottic BVM N/A

Field Receiving Blood

Yes No

Prehospital FAST

Positive Negative N/A

Prehospital FAST Pericardial Window

Positive Negative N/A

End Tidal CO2 Reading Available

Yes No

Base Deficit Reading Available

Yes No

Head/Neck

Depressed Skull Fracture Penetrating Injury Large Laceration Difficulty Breathing/Speaking/Swallowing Pulsatile Bleeding N/A

Focal Neurologic Deficit

Yes No

Abdomen

Penetrating Injury Unstable Pelvis Evisceration N/A

Chest

Flail Chest Open "Sucking" Wound N/A

Extremities

Open Fracture Tourniquet Pulsatile Bleeding Pulseless Extremity Partial or Complete Amputation N/A

Do you think the patient should go directly to the operating room?

Yes No