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


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
UE Non-displaced Sling
  Displaced Pre-fabricated splint
LE Wheelchair, elevation
  • Elevate above heart as soon as possible
  • Remind patient/family – no fluids or food