Trauma Resuscitation — Considerations for Trauma Labs in Trauma Level 1 or 2 Activations — Clinical Pathway: Emergency

Trauma Resuscitation Clinical Pathway — Emergency Department

Considerations for Trauma Labs in Trauma Level 1 or 2 Activations

There is no clear evidence to support routine laboratory tests in trauma activations.

  • Consider obtaining Trauma Alert labs based on mechanism of injury and/or clinical presentation.
  • Trauma Alert labs are indicated for Hemodynamically unstable patients.

Specimen Tubes Needed for Trauma Labs

  • Consider obtaining all potentially required tubes while obtaining IV Access.
  • Initial Screening for most Trauma 1 & 2 Activations requires at a minimum
    • 2 Lavender (EDTA) and 1 Gold tube (Clot Activator)
  • Prioritization for tubes: 1) 3 Lavender (EDTA), 2) 1 Gold (Clot Activator) , 3) 1 Light Blue (sodium citrate) and 4) 1 Light Green (Lithium Heparin)
Labs Indications Comments
CBC
  • Send as clinically indicated
    • Consider MOI, Clinical exam
  
Type & Screen
Type & Cross
  • Consider MOI
  • Clinical exam
  • Possible emergent/urgent operative intervention
  • Obtain 2 specimens
    • Two separate times by two separate providers
Basic Metabolic Panel
  • Baseline for most activations; with concern for fluid shifts, electrolyte abnormalities or TBI
  • TBI
  • Fluid, blood resuscitation
PT/PTT
  • Concern for continued bleeding and/or TBI
  • Blood resuscitation
Blood Gas Profile
ISTAT
  • Concern for shock
  • Respiratory failure
  • Hemodynamically unstable
  • Intubation, ventilation needed
Hepatic Function
Panel
Amylase
Lipase
  • Concern for intraabdominal trauma
  • Consider UA for patients with concern for significant intra-abdominal trauma
Urinalysis w/o Microscopic
  • Concern for intraabdominal trauma
  • Consider UA for patients with concern for significant intra-abdominal trauma
Serum Drug Screen
Alcohol Serum Screen
Urine Drug Screen
  • Based on history, clinical exam, mechanism of injury
  • Consider if concern for ingestion, attempted suicide
Urine/Serum Pregnancy
  • All female pts over age 12 or any age post-menarche
  • Consider serum pregnancy if delay to urine