This is not the complete plan some parts have been omitted as they appear in other sections of this web site. If you would like a complete copy please contact the WC-RTAC Coordinator for one.

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The Trauma Plan

West Central Regional Trauma Advisory Council

Introduction

The geographic region of the West Central Regional Trauma Advisory Council (WC-RTAC) includes all of Pierce, Polk, and St. CroixCounties in Wisconsin.  Hospitals from Barron, Burnett, and WashburnCounty have designated to the WC-RTAC.  Those three counties also have designated facilities and transport agencies that belong to other RTAC’s.  A transport service from BarronCounty is included as well as transport services from Eastern Minnesota.  The WC-RTAC’s resource hospital is a level one trauma facility in St. PaulMinnesota.

The WC-RTAC holds bi-monthly meetings on the third Thursday of odd months at 6:30 pm.  Hospitals are required to attend.  All others of the membership are encouraged to attend.

A representative from the WC-RTAC, in the more recent past the WC-RTAC Coordinator, attends state meetings.  A representative has and is required to attend 75% of these meetings.  These meetings include RTAC Coordinator meeting and STAC (State Trauma Advisory Council).  Other meetings attend at the State level may include:  STAC working committee, Trauma Coordinators, Hospital Registrars, EMSC (Emergency Medical Services for Children), EMS Advisory, and any sub-committee meetings at the state level.

The WC-RTAC has four active committees at a regional level.  The Executive Council, Performance Improvement, Injury Prevention, and Emergency Preparedness.  All active WC-RTAC members are encouraged to be a member of, at least, one committee.

First Responders, dispatch personnel, emergency management, law enforcement, public health and fire agencies are invited to meetings and appropriate trainings.  Personnel from these agencies are sent emails, phone calls, or face-to-face encounters to encourage them to attend meetings or to educate them about the Wisconsin Trauma System.  These groups have attended meetings at various intervals.

The WC-RTAC is striving to provide timely quality care for trauma patients in the Western Wisconsin area.

West Central RTACMission Statement

The mission of the WC-RTAC is to promote quality and accessible trauma care and to promote the progression and personal development of its individual and organizational members.

Triage & Transport Guidelines

Identification of the major trauma patient is essential to trauma system design because it describes the patient who will benefit most from regionalized care. It also indirectly determines the level and intensity of resources needed to provide definitive care. Triage includes the process of sorting patients as to severity or injury risk and assigning them to the most appropriate resource for definitive care. Triage decisions are made at the scene during the initial evaluation of the victim. Once made, decisions impacting destination include severity of the injury sustained by the victim, time and distance to a receiving facility, and level of hospital resources available to care for the trauma victim. Triage criteria should provide a basis for the establishment of protocols for patient identification, delivery decisions, and appropriate response at the acute care facilities for all trauma patients in an inclusive system.

The Bureau of Local Health Support and EMS in collaboration with the State Trauma Advisory Council and trauma system participants have established the following Triage and Transport Guidelines for the State Trauma System and shall serve as the minimal guidelines each EMS provider shall incorporate into their operational plans.

EMS Guidelines

Activate local trauma plan

1. Patient is unresponsive to voice commands.
2. Penetrating injury to head, neck, torso, or proximal extremity.
3. Unstable blood pressure.
4. Heart rate:
   < or = 5 years old (<80/min or >180/min) and
   > or = 6 years old (<60/min or >160/min).
5. Respiratory rate less than 10 or greater than 30 (pediatric >60/min with signs of respiratory distress).
6. Trauma with burns with greater than 15% BSA.
7. High voltage injuries.
8. Ineffective breathing (grunting or stridor in children).
9. Signs of shock (signs of poor perfusion in children).
10. Distended, rigid abdomen.
11. Flail chest
12. Two or more proximal long bone fractures.
13. Depressed or open skull fracture.
14. Pelvic fracture.
15. Amputation proximal to wrist or ankle.
16. Acute paralysis.

Activation of trauma plan may include:

• Dispatch nearest ALS service for intercept
• Dispatch closest available air ambulance.

Consider activation of trauma plan

1. Ejection from vehicle.
2. Death of another occupant of same vehicle.
3. Falls greater than 20 feet (3x patient height for pediatrics).
4. Vehicle roll over.
5. High-speed motor vehicle crash.
6. Major deformity of vehicle.
7. Vehicle vs. pedestrian or bicycle.
8. Any motorcycle, snowmobile, or ATV crash.
9. Large animal related injuries (livestock, horse, horse buggy crash etc.).
10. Trauma patient less than 5 years old or greater than 55.
11. Trauma patient who is pregnant.
12. Trauma patient who is immunosuppressed.
13. Trauma patients who have a bleeding disorder or on anticoagulant therapy.

Needs for Populations Currently Not Active In WC-RTAC

The WC-RTAC has become more known to the populations that have not been active or well informed about the State and Regional Trauma Advisory Council’s.  Listed below are entities that have been identified as populations who are needed to be included as participants or at least be educated of the activities of the RTAC.

Identifiable populations would be:

  1)  Public Health

  2)  Fire based agencies

  3)  Law Enforcement

  4)  Emergency Management

  5)  Dispatch

  6)  Village/City Government

  7)  Schools

  8)  Residents

Currently the WC-RTAC has had active participation from public health, dispatch, and emergency management.

The RTAC has and is continuing to invite and communicate with Public Health, Fire, Law Enforcement, Emergency Management, and Dispatch.  These communications may include attending those entities meetings, emails, phone calls, mailings, or face-to-face encounters.  The RTAC has been working with these entities to collaborate in tabletops, functional exercises, and live exercises.  The benefit of this is to pool resources and to include all essential agencies.  This is planning to be continued.  The preparedness committee has been charged with creating the foundation and plan for this effort. 

The Village/City governments will be educated on the trauma system with information in regards to what the RTAC/STAC is about and other informative material that will be designed specific to their needs.

The Injury Prevention Committee is charged with collaborating with the appropriate groups, which have included Law Enforcement, Public Health and Fire, to plan events and educate that will educate the community and school populations.  The residents of the communities will benefit from the injury prevention projects that the RTAC committee is working on.

The WC-RTAC will continue to work on efforts to educate and collaborate with identified populations for the growth of the trauma care system.

IDENTFIED NEEDS FROM 2005 ASSESSMENT

The WC-RTAC EMS agencies were involved in a needs assessment that was completed in February of 2005.  Three items have been identified as needs from this.  These needs will be addressed starting in 2007 – 2008.

I.  Communication

    These are listed in the order of concern as identified from the needs assessment.

    A.  Communication between EMS and Hospitals

    B.  Communication between Dispatch and EMS

    C.  Communication between EMS and EMS

    D.  Communication between EMS and Fire/Law

II. Wearing and Identifying of Appropriate PPE 

      A.  Wearing of appropriate PPE at all times

      B.  Identification of what types of PPE to be wearing for the situation

III. Recruitment and Retention of EMS Personnel

       A.  Recruitment of qualified EMS personnel

       B.  Retention of qualified EMS personnel 

WC-RTAC