(a) Patients meeting trauma criteria. Patients who meet the trauma criteria as outlined in 20 CAR § 80-203 shall be transported to the most appropriate trauma center based on ATCC recommendation unless the:

1. (1)

   1. (A) EMS provider is unable to establish or maintain an adequate airway or control excessive hemorrhage.
   2. (B) In these cases, the patient shall be transported to the nearest hospital able to provide the appropriate care; or

2. (2)

   1. (A) ATCC recommends a specific trauma center and the patient refuses to be transported to that facility.
   2. (B) In this case, the EMS provider shall fully inform the patient of the limited capacity and capability of the patient’s chosen facility.
   3. (C) The EMS provider has the discretion to transport the patient to the most appropriate trauma center to treat the patient’s specific injuries (Acts 2009, No. 553, Arkansas Code § 20-13-1003).
   4. (D) Licensed ambulance services shall appropriately triage all traumatically injured patients using the Field Triage Decision Scheme: The Arkansas Trauma Triage Protocol.
   5. (E) The lead EMSP will make the destination decision considering the ATCC recommendation, patient’s condition, distance of travel, patient preference, and system status.
   6. (F) If the patient refuses to be transported to the ATCC-recommended trauma center and the EMS provider decides to take him or her to the patient’s facility of choice, the EMS provider shall document the patient’s refusal.

(b)

1. (1) Trauma bands shall be placed on all trauma patients who will be transported to a trauma center.
2. (2) Once applied to a trauma patient, the trauma band number shall be recorded on the patient care record.

(c)

1. (1) An EMS provider shall complete a radio report to the trauma center at least fifteen (15) minutes prior to patient arrival.
2. (2) If transport time is less than fifteen (15) minutes, contact shall be made as far in advance of arrival as possible.

(d)

1. (1) The EMS provider shall, at the time of transfer of care, leave a completed encounter form or a completed short form.
2. (2) If a short form is left with the receiving trauma center, the ambulance service shall submit a completed encounter form within twenty-four (24) hours of transfer of care.

(e)

1. (1) An EMS provider shall maintain a minimum of two (2) backfill agreements to be utilized in order to maintain service area coverage should the provider need to leave its service area for emergency trauma responses.
2. (2) EMS providers shall participate in all QI reviews that involve care provided by the EMS service.
3. (3) These may occur at any level of the trauma system (e.g., the trauma center, the TAC QI/TRAC Committee, or the TRAC QI Committee).