ED Pathway for Evaluation/Treatment of Child with a Suspected Extremity Fractures

Triage

Trauma - Extremity

1 Critical 2 Acute 3 Urgent 4 Urgent 5 Non-Urgent
  • Trauma with uncontrollable bleeding or hemodynamic compromise
  • Digit amputation

  • Open fracture

  • Femoral point tenderness, edema

  • Impaired distal neurovascular status

  • Absent perfusion to extremity

  • Laceration repair needing xray or sedation

  • Nailbed injury

  • Dislocated distal joint

  • Displaced fracture

  • Dislocated proximal joint

  • Suspected Nursemaid’s elbow

  • Suspected clavicle fracture

  • Mild swelling without deformity of ankle in children > 13 years of age

  • Edema over injury

  • Simple laceration repair

  • Point tenderness

  • Abrasion

     

Assess and document skin integrity and neurovascular status distal to the injury.

Analgesia Motrin as per Triage protocol
Severe pain, expedite transfer to ED room
Ice Apply cold pack or ice bag wrapped in cloth to injured extremity for 15-20 minutes
Repeat as necessary
Splint/Sling
UE Non-displaced Sling
  Displaced Pre-fabricated splint
LE Wheelchair, elevation
Elevation
  • Elevate above heart as soon as possible
NPO
  • Remind patient/family – no fluids or food