"Loss of Consciousness"

[Richard B the EMT]

Again MCI triage protocols. These do not apply to single patients where they get a full trauma assessment. Not the very abbreviated and fast MCI triage tags of black, red, yellow and green.

Are the powers that be considering the new Orange level in the Triage Tag protocols in your area yet?

[nypamedic43]

I dont know if they are or not Richard.

[Asysin2leads]

Protocols shmotocols. If your trauma patient reports loss of consciousness, or somebody else does, take them some place capable of looking inside and preferably being able to fix their noggin. Sorry for the technical terms.

[ERDoc]

One thing I have noticed is that when I was working in NY, hardly anyone ever reported a loss of consciousness. Those that did were usually still unconscious when they got to the ER. Here in MI, it feels like 90% of people report a loss of consciousness. I'm not sure what to make of it, but it is something I've noticed.

[p3medic]

I've always made the assumption that no recall of event = presumed LOC until proven otherwise.

[Chris Smith]

I was referring to the national trauma triage protocol. There is no mention of LOC. wouldn't you think if that had some evidence behind it it would be included?

[Richard B the EMT]

"One moment, I was standing alone, the next, I was on the floor with a bunch of people and you ambulance drivers standing over me"

Patient says that to me, presumptive Loss of Conciousness, and lecture on calling us Ambulance Drivers when enroute to hospital

[tcripp]

I was referring to the national trauma triage protocol. There is no mention of LOC. wouldn't you think if that had some evidence behind it it would be included?

I have never seen this before, so thanks for bringing it to my attention. However, the first box does include "LOC" whether you look at it as "loss" or "level". This page seems very simplistic and I'm glad our local protocols vary as much as they do.

[DFIB]

I have never seen this before, so thanks for bringing it to my attention. However, the first box does include "LOC" whether you look at it as "loss" or "level". This page seems very simplistic and I'm glad our local protocols vary as much as they do.

I think this protocol is complicated and long winded for an MCI situation. Vital signs during triage would take a awful long time although it appears to be simply directed at the single transport decision.

[ERDoc]

Obviously LOSS of consciousness and LEVEL of consciousness are two different things. I don't think LOSS is very reliable as I previously mentioned, as it is so subjective unless it was witnessed by EMS. I find it hard to believe that 75-90% of the MVA pts I see truly lost consciousness. Level is a good assessment tool since a prolonged decreased LOC is a reliable sign and usually comes from some sort of neurological injury. It can also be continuously assessed to determine if a pt is deteriorating or improving. I think in an MCI situation it is important because those with decreased LOC are the ones that will have airway issues, which obviously we want to treat first.