Hi, I have a question in relation to the FTT standard. If I had a patient who was VSA on arrival due to a multi-system trauma (no penetrating injuries, only blunt), but does not qualify for trauma TOR because the closest ED is 10 minutes away but LTH is 20 minutes away... am I transporting to the ED or the LTH? I understand for penetrating injuries we are going to LTH if it's < 30 minutes, regardless of vital signs... but for other situations like the one I am stating, what is the appropriate action?

The case you describe with the patient being VSA from trauma and not meeting Trauma TOR criteria, should be transported to the closest hospital.

Within the FTTS, Step One (Physiologic) is the following: If a paramedic is unable to successfully manage the airway or the patient is unlikely to survive transport to the LTH, the patient must be transported to the closest Emergency Department (ED).  Given these patients are in cardiac arrest, they should be transported to the closest Emergency Department. Please note, also written into the Traumatic Cardiac Arrest is, If the BH patch fails, or the Trauma TOR does not apply, transport to the closest appropriate receiving facility following the 1st analysis/defibrillation. This would be the closest Emergency Department.

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