If step one or two criteria met, transport to highest level of care<unk>  center. If step three criteria met, transport to<unk>  center, but not necessarily highest level. If step four criteria met, transport to<unk>  center or hospital capable of timely and thorough evaluation. When in doubt, transport to a<unk>  center
Glasgow Coma Scale ≤13, or
SBP of <90 mmHg, or
Respiratory rate of <10 or >29 breaths per minute (<20 in infant aged <1 year), or need for ventilatory support
All penetrating injuries to head, neck, torso, and extremities proximal to elbow or knee
Chest wall instability or deformity (e.g. flail chest)
Two or more proximal long-bone fractures
Crushed, degloved, mangled, or pulseless extremity
Amputation proximal to wrist or ankle
Pelvic fractures
Open or depressed skull fractures
Paralysis
Falls
Adults: >20 feet (one story = 10 feet)
Children: >10 feet or two to three times the height of the child
High-risk auto crash
Intrusion, including roof: >12 inches occupant site; >18 inches any site
Ejection (partial or complete) from automobile
Death in same passenger compartment
Vehicle telemetry data consistent with a high risk for injury
Automobile versus pedestrian/bicyclist thrown, run over, or with significant (>20 mph) impact
Motorcycle crash >20 mph
Adults: >20 feet (one story = 10 feet)
Children: >10 feet or two to three times the height of the child
Intrusion, including roof: >12 inches occupant site; >18 inches any site
Ejection (partial or complete) from automobile
Death in same passenger compartment
Vehicle telemetry data consistent with a high risk for injury
Older adults
Risk for injury/death increases after age 55 years
SBP <110 might represent shock after age 65 years
Low impact mechanisms (e.g., ground-level falls) might result in severe injury
Children
Should be<unk> d preferentially to pediatric capable<unk>  centers
Anticoagulants and bleeding disorders
Patients with head injury are at high risk for rapid deterioration
Burns
Without other<unk>  mechanism:<unk>  to burn facility
With<unk>  mechanism:<unk>  to<unk>  center
Pregnancy >20 weeks
EMS provider judgment
Risk for injury/death increases after age 55 years
SBP <110 might represent shock after age 65 years
Low impact mechanisms (e.g., ground-level falls) might result in severe injury
Should be<unk> d preferentially to pediatric capable<unk>  centers
Patients with head injury are at high risk for rapid deterioration
Without other<unk>  mechanism:<unk>  to burn facility
With<unk>  mechanism:<unk>  to<unk>  center
Field trauma triage
Mass casualty incident triage
Pediatric assessment triangle
Combat triage
Critical care documentation
Sign out tools
Documentation for emergency physicians
Tactical field care