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Alameda County
Emergency Medical Services Agency
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Adult Emergency Trauma Re-Triage
Effective: 8/24/2023
Review: 8/24/2026 Approved: Link to Record of Revisions and Approvals
I. Purpose
This policy is intended for adult patients whose needs are generally known immediately or
soon after initial arrival, based on clinical findings. Avoid any unnecessary studies (e.g. CT
scans or angiograms), and do not delay transport for paperwork/diagnostics not ready at the
time of departure.
II. Procedure
STEP ONE – Determine Level of Severity
Blood pressure / perfusion: Systolic pressure < 90 or Need for high volume fluid resuscitation (> 2 L NS) or immediate blood replacement
GCS / Neuro GCS Less than 9
GCS Deteriorating by 2 or more during observation Blown pupil Obvious open skull fracture
Anatomic criteria Penetrating injuries to head, neck, chest, or abdomen Extremity injury with ischemia evident or loss of pulses Provider judgment Patients who have a high likelihood of need for emergent life- or limb-saving surgery or
STEP TWO – Arrange Emergency Transport
Contact the Trauma Center: ED to ED communication to confirm acceptance of the patient to the closest most appropriate Trauma Center.
Call 9-1-1 Directly: Request a “Code 3 Ambulance” for an “emergency trauma re-triage” patient.
Alameda County
Emergency Medical Services Agency
Click here for all Administrative Policies 2 | P a g e
Paramedic or EMT in the ambulance during transport, or arrange for a Critical Care Transport (CCT) ambulance instead
STEP THREE – Send Additional Paperwork
Prepare Paperwork/Diagnostics: Send any additional paperwork not ready at the time of
patient departure. (See Trauma Center Contact Information table below). Do not delay transport for paperwork or diagnostic imaging.
Trauma Center Contact Information
Trauma Center Contact Number for Acceptance Fax Number for Paperwork/Diagnostics
Eden Medical Center (510) 566-3039 (510) 727-3355
Highland (ACMC) (510) 535-6000 (510) 535-7791