CRITERIA FOR NON-ACCEPTANCE AND IMMEDIATE REFERRAL (MAJOR INJURIES/TRAUMA): The following types of injuries or associated conditions are generally not accepted for definitive treatment within ASSH -ER-Minor procedure room and require immediate referral to a higher level of care (e.g., Trauma Center).
1. Head Injuries: Any head injury with loss of consciousness, altered mental status, persistent vomiting, severe headache, neurological deficits, or suspicion of intracranial injury.
2. Major Lacerations: Deep lacerations involving muscle, tendon, nerve, bone, or joint capsule; lacerations with significant bleeding; lacerations requiring extensive debridement or complex repair. Lacerations exceeding the defined limits for minor lacerations.
3. Major Burns: Second-degree burns exceeding 5% TBSA, any third-degree burns, burns involving critical areas (face, hands, feet, perineum, major joints), circumferential burns, or suspicion of inhalation injury.
4. Penetrating Injuries: Stab wounds, gunshot wounds, or any injury where internal organ damage is suspected.
5. Major Trauma: High-energy impact injuries (e.g., motor vehicle accidents, falls from height) with potential for multiple injuries or internal organ damage.
6. Abdominal or Thoracic Trauma: Any injury to the chest or abdomen with suspicion of internal bleeding or organ damage.
7. Eye Injuries: Penetrating eye injuries, chemical eye burns, severe blunt trauma to the eye, or vision loss.
8. Injuries with Significant Blood Loss: Any injury causing active, profuse bleeding that cannot be easily controlled by direct pressure.
9. Vascular or Neurological Compromise: Any injury leading to suspicion of compromise to blood flow or nerve function distal to the injury.
10. Ingested Foreign Bodies/Toxins: Where there is a concern for airway compromise, internal injury, or systemic toxicity.
11. Child Protection Concerns with related injury: Any injury where child abuse or neglect is suspected Immediate first aid and follow policy
12. Sexual Assault injury: Immediate first aid and follow policy
13. Medico legal cases: Immediate first aid and follow policy