Emergency Department Clinical Pathway for Children Meeting Trauma Activation Criteria
- Related Pathways
- Abdominal Solid Organ Injury, ED, Inpatient, and ICU
- Abuse, Physical, ED
- Abuse, Sexual, Suspected
- Airway, Difficult/Critical
- Brain Injury, Severe Traumatic
- Burn Injury
- End of Life Care
- Fracture, Extremity, Suspected
- Fracture, Open Long Bone
- Fracture, Pelvis
- Head Trauma, Acute
- Hemophilia with Head Trauma
- Nutrition for the Traumatically Injured Patient, ICU
- Spinal Cord Injury SCI, Traumatic
Patient arrival to ED
0 min
Primary Survey: Organized Evaluation to identify life threats and Intervene
Respiratory |
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Circulatory |
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Neurologic |
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Interventions | ||
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C | Catastrophic Hemorrhage | Identify and control active exsanguination |
A | Airway, C-Spine |
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B | Breathing |
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C | Circulation |
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D | Disability, Dextrose |
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E | Exposure |
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Log Roll: Immediately after primary survey completion
Secondary Survey: Organized Evaluation to identify all injuries
Imaging Considerations | Per Trauma Attending/Fellow, ED Attending/Fellow - Prioritize triaging imaging |
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Plain films X-ray | C-Spine, chest, pelvis, injured extremities |
Computerized tomography (CT) | Non-contrast Head CT (consider C1-C2) abdominal CT IV contrast, chest CT IV contrast |
Considerations for Pediatric eFAST Nasogastric/orogastric tube, foley |
Ongoing Care: Stabilization and Considerations for Disposition
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20 min
|
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Medical Examiner
PICU
OR
Med/Surg
ED Exam Room
Discharge Home
Reviewed by Children's Hospital of Philadelphia Trauma Committee: November 2019
Posted: January 2020
Revised: February 2023
Authors: H. McCorkle, CRNP; D. Perks, CRNP; S. Meyers, MD; G. Nace, MD; S. Fesnak, MD; MK. Abbadessa, ACCNS-P;
J. Connelly, CRNP; S. Gaines, RN; J. Lavelle, MD
Posted: January 2020
Revised: February 2023
Authors: H. McCorkle, CRNP; D. Perks, CRNP; S. Meyers, MD; G. Nace, MD; S. Fesnak, MD; MK. Abbadessa, ACCNS-P;
J. Connelly, CRNP; S. Gaines, RN; J. Lavelle, MD
Evidence
- Screening for Blunt Cerebrovascular Injuries in Pediatric Trauma Patients
- A Cohort Study of Blunt Cerebrovascular Injury Screening in Children: Are They Just Little Adults?
- Identifying Children at Very Low Risk for Blunt Intra-abdominal Injury in Whom CT of the Abdomen Can Be Avoided Safely
- High Volume Crystalloid Resuscitation Adversely Affects Pediatric Trauma Patients
- Student Course Manual ATLS® Advanced Trauma Life Support
- Consistent Screening of Admitted Infants with Head Injuries Reveals High Rate of Nonaccidental Trauma
- Pediatric Massive Transfusion: a Systematic Review