Kern County Protocols (Updated 2024) – Questions With Complete Solutions Red Criteria (High risk for serious Injuries: Injury Patterns Correct Ans - Penetrating injuries to head, neck, torso, and proximal extremities Skull deformity, suspected skull fracture Suspected spinal injury with new motor or sensory loss Chest wall instability, deformity, or suspected flail chest Suspected pelvic fracture Suspected fracture of two or more proximal long bones Crushed, degloved, mangled, or pulseless extremity Amputation proximal to wrist or ankle Active bleeding requiring a tourniquet or wound packing with continuous pressure
Red Criteria (High risk for serious Injuries): Mental Status and Vital Signs
Correct Ans - All Patients Unable to follow commands (motor GCS < 6) RR < 10 or > 29 breaths/min Respiratory distress or need for respiratory support Room-air pulse oximetry < 90% Age 0-9 years SBP < 70mm Hg + (2 x age years) Age 10-64 years SBP < 90 mmHg or HR > SBP Age ≥ 65 years SBP < 110 mm/g or 1 / 3
HR > SBP
YELLOW CRITERIA (Moderate Risk for Serious Injury): Mechanism of Injury
High-Risk Auto Crash Partial or complete ejection Significant intrusion (including roof) >12 inches occupant site OR >18 inches any site OR Need for extrication for entrapped patient Death in passenger compartment Child (Age 0-9) unrestrained or in unsecured child safety seat Vehicle telemetry data consistent with severe injury Rider separated from transport vehicle with significant Impact (eg, motorcycle, ATV, horse, etc.) Pedestrian/bicycle rider thrown, run over, or with significant impact Fall from height > 10 feet (all Correct Ans -
YELLOW CRITERIA (Moderate Risk for Serious Injury): EMS Judgement
Correct Ans - Consider risk factors, including:
Low-level falls in young children (ages 5 years) or older adults (age 65 years) with significant head impact Anticoagulant use Suspicion of child abuse Special, high-resource healthcare needs Pregnancy > 20 weeks Burns in conjunction with trauma Children should be triaged preferentially to pediatric capable centers 2 / 3
If concerned, take to a trauma center Patient can go directly to an emergency department walk-in waiting room and Must meet following criteria? Correct Ans - Patients 18 years of age or older Minor accompanied by a responsible adult The patient can sit unassisted and has reasonable mobility The patient does not have peripheral IV access The patient is not on a 5150 hold or in custody Patient vital signs: Adults:
Pulse: 50-120 bpm
Systolic Blood Pressure: 100-180
Diastolic Blood Pressure: Less than 120
Respiratory Rate: 12-30
Pediatrics Vital signs:
Appropriate for age. (Refer to Handtevy Mobile App) If hospital staff decline to sign ePCR, the EMS crew shall document the staff's name in the narrative and "refused to sign" in the signature box.The patient, If the criteria are met, can be taken directly to the ED walk-in waiting room.MICN approval is not required if the patient is escorted through the public entrance Cardiac Monitor Policy Correct Ans - The cardiac monitor may be removed if the patient is not being treated under ALS protocol OR stable pre- ex rhythm (atrial fibrillation, bradycardia, etc.) Patients treated under ALS protocol requiring cardiac monitoring shall remain on cardiac monitor until transfer care is complete.
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