TITLE: EMS – Trauma Field Triage and Transport Destination Protocol

DOCUMENT #: 2022-4-EMSC

DATE ADOPTED: July 15, 2022

ADOPTED BY: Indiana Emergency Medical Services Commission (EMSC)

This document clarifies the requirement of complying with the Trauma Field Triage and Transport Destination Protocol which is listed in 836 IAC 1-2.1 of the EMSC rules.

The Trauma Field Triage and Transport Destination Protocol was adopted in 2012 and re-adopted in 2018. 836 IAC 1-2.1-6 adopts by reference "Guidelines for Field Triage of Injured Patients - Recommendations of the National Expert Panel on Field Triage". Announced on May 3, 2022, by the National Office of EMS, the American College of Surgeons updated the national Field Trauma Triage Guidelines (FTTG) and adopted the 2021 Field Triage Guidelines as an update to the 2011 guidelines. The 2021 guidelines are being implemented within the ACS trauma system and have been endorsed by the State Trauma Committee. The challenge is that with the rule directly adopting the 2011 guidelines, EMS providers need guidance on whether to be permitted to utilize the updated 2021 guidelines while a rule change is pursued.

The intent of 836 IAC 1-2.1-1 is "to provide a regulatory plan to ensure that injured patients in the pre-hospital setting are transported to the most appropriate hospital facility within the Indiana state trauma system based on field assessment by emergency medical services personnel of the potential severity of injury, available transportation, and hospital resources.". The current rule is a minimal threshold to meet this purpose. The new ACS 2021 Field Trauma Triage Guidelines (FTTG) are medically sound and, if approved by local medical direction, may be adopted. A provider organization or individual that operates, with medical director written approval, under the 2021 ACS FTTG is compliant with the Trauma Field Triage and Transport Destination Protocol, since the newer version meets the basic qualifications of the 2011 version.