"Loss of Consciousness"

[Chris Smith]

My system has an obsession for "loss of consciousness" in trauma patients. It's in there report, the doc's ask about it, yet its no part of trauma triage protocols. Please explaim why anyone would be so stuck on this concept?

Edited March 2, 2012 by EMT City Administrator
-Title Change

[nypamedic43]

Loss of consciousness changes treatment plans. A positive LOC could mean a concussion. A coup-contra coup injury that causes LOC could mean a bleed in the brain or a brain injury that could cause swelling of the brain.

It isnt an obsession or being stuck on the the concept of LOC...its a conscious effort by professional health care providers to be ahead of the game in a treatment plan.

To what trauma "triage" protocols are you referring to? Asking about LOC is one of the first questions we ask in the case of trauma. Even if there is no evidence of injury.

Edited December 28, 2011 by nypamedic43

[mobey]

Triage is based on immediate life threats. A history of LOC is not an immediate life threat.

Loss of consciousness should be part of your history taking, and subsequent report, but is not involved in triaging patients.

If you do not know why a history of LOC is important, I suggest a google search. If you are an EMT or first responder at any level, I suggest taking an ITLS course.

Just a tip: Titles such as 'HELP!' suck!

Perhaps "Why is LOC important?" or "Triage and LOC" would have been more appropriate since you do not actually need "help".

Since I haven't seen your introductory thread: Welcome

Edited December 28, 2011 by mobey

[Chris Smith]

It's an important factor to consider, but no where in the trauma triage protocol's does "loss of consciousness" mean this patient MUST be referred to a trauma center.

[Bernhard]

Because it's an indicator for severity of head trauma. A lousy one, but if (temporary) loosing consciousness then the hit to the head was more than just a slight bump and a perfect oriented patient may be upgraded to a possible commotio cerebri or even more, with a bit surveillance time needed. Lousy therefore because initial bystander responders almost never can give a certain report on this (if they even are able to detect lost consciousness).

Refer to mobey's posting for the rest.

[mobey]

It's an important factor to consider, but no where in the trauma triage protocol's does "loss of consciousness" mean this patient MUST be referred to a trauma center.

Sounds like your protocol's suck.

You do realize that not everyone uses your regions protocols right?

Just a point of clarafication: Perhaps not a level 1 trauma centre.... but a CT equipped major hospital should be considered.

[DwayneEMTP]

Do your protocols really need to tell you that?

Chris, you obviously have a bone to pick here somewhere. Why not just lay it out so we can discuss it?

Did you get jammed up for not transporting a LOC trauma to a trauma facility?

Dwayne

[tcripp]

...yet its not part of trauma triage protocols.

I'm assuming you mean your own protocols. So, have you asked your command about that?

Also, what is your level?

[paramedicmike]

I think if you want to know why receiving docs are so stuck on whether there was a loss of consciousness you should be asking them why they're so stuck on a loss of consciousness. That seems like the most direct source to get an answer to your question.

[DFIB]

During Patient Assessment the LOC is determined even before we evaluate and manage Airway and Circulation during the initial assessment. I use the AVPU or GCS.

I consider the level of consciousness pretty important at my basic level because there is a reason I cannot see and probably will not be able to manage for a prolonged time. A rapidly diminishing LOC can be indicative of so many different conditions that information about the conditions of the loss of consciousness is pretty important.

BSI

SCENE SIZE UP

Determines the scene is safe

Determines the mechanism of injury

Determines the number of patients

Requests additional help if necessary

Considers stabilization of spine

INITIAL ASSESSMENT

Verbalizes general impression of the patient

Determines responsiveness / level of consciousness (Bold to mark place in assessment)

Determines chief complaint / apparent life threats

If you are talking about triage in the event of an MCI we use START triage. It evaluates AMS and LOC as a significant finding.

Edited December 28, 2011 by DFIB