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Overview :
Trauma patients
may be triaged based by whether or not they are physiologically stable.
Criteria for
being considered unstable:
(1) Glasgow coma scale <=
14
(2) pulse <
60 or > 120 beats per minute
(3) blood
pressure < 90 mm Hg after a crystalloid fluid challenge of 2 liters
(4) systolic
blood pressure > 190 mm Hg
(5) respiratory
rate < 12 or > 24 breaths per minute
(6) poor gas
exchange, with oxygen saturation < 90%
(7) temperature
< 92°F (< 33°C)
(8) paralysis
(9) hoarseness
or inability to talk
(10) labored
respirations
(11) severe pain
(12) external
hemorrhage
(13) combative
(14) severe
deformity involving spine, neck, chest or extremities
(15) penetrating
wound from head to popliteal fossa
Comorbid
conditions increasing the risk for being unstable:
(1) age > 55
years
(2) history of
coronary artery disease
(3) history of
COPD
(4) history of
liver disease
(5) history of
coagulation disorder
(6) history of
mental illness
(7) current
insulin-dependent diabetes mellitus
(8) current
anticoagulation therapy
(9) current
pregnancy
where:
• I would think
a Glasgow coma
score of 14 might be considered stable.
• I would have
thought that neonates might also be considered at risk.
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