The Commonwealth of Massachusetts

Executive Office of Health and Human Services
Department of Public Health
Bureau of Health Care Safety and Quality
99 Chauncy Street, 2nd Floor, Boston, MA 02111
617-753-8000 

DEVAL L. PATRICK
GOVERNOR
TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR
JUDYANN BIGBY, MD
SECRETARY
JOHN AUERBACH
COMMISSIONER	
CIRCULAR LETTER: DHCQ 10-03-532

TO:		Chief Executive Officers
		Acute Care Hospital

FROM:	Alice Bonner, Ph.D., RN
		Director, Bureau of Health Care Safety and Quality
 
RE:		Update to Trauma Field Triage Criteria and Point of Entry Plan for Trauma Patients
                        Transported by Air Medical Ambulance Services

DATE:		March 4, 2010

The purpose of this memo is to notify you that the Department has updated the Statewide Trauma Field Triage Criteria and Point-of-Entry Plan for Adult and Pediatric Patients with regard to trauma patients being transported by air medical ambulance services. 

Air ambulance service resources are intended to provide a vital link between the most seriously injured patients and the highest level of trauma care available.   As these resources are expensive, finite and involve risk to both patients and caregivers, appropriate utilization and appropriate integration with EMS and trauma systems is critical.     

Patients requiring air ambulance transport have severe injuries.  Consistent with the Centers for Disease Control recommendations published in Morbidity and Mortality Weekly Report (MMWR), January 29, 2009  Correction added 3/23/2010; Morbidity and Mortality Weekly Report (MMWR), January 23, 2009, and the recommendations of the State Trauma Committee, patients with severe injuries should be transported to the highest level of care. This recommendation is consistent with other published literature on trauma outcomes.  
 
Attached please find the updated Statewide Trauma Field Triage Criteria and Point-of-Entry Plan for Adult and Pediatric Patients. Please note that effective the date of this letter, the plan requires all trauma patients transported by air ambulance (whether transferred from the scene of incident or as an interfacility transfer) to be delivered to the closest, appropriate ACS level 1 trauma center with helipad facilities. 
 
As more specific outcome data from the Statewide Trauma Registry become available, the Department may revise the Statewide Trauma Field Triage Criteria and Point-of-Entry Plan for Adult and Pediatric Patients from time to time by notice of circular letter.

The Statewide Trauma Field Triage Criteria and Point-of-Entry Plan for Adult and Pediatric Patients is available on the Department’s website, at www.mass.gov/dph/oems. On that page, click on “Trauma Centers,” and on the Trauma Data and Verification Page, click on the topic, “Trauma Field Triage Criteria.”
For other questions about this correspondence please contact Gail Palmeri, Program Manager, at 617-753-8230, or email gail.palmeri@state.ma.us. 

REGULATORY AUTHORITY: M.G.L. c. 111C, §11