Pediatric Trauma
This vital sign may appear normal despite significant blood loss in children.
What is blood pressure?
Required document for initial charting for Level 1 and Level 2 Traumas.
What is the Trauma Flow Sheet?
This parameter is the most sensitive early indicator of hemorrhagic shock in a healthy, young, adult trauma patient.
What is heart rate?
If/when possible, patients arriving via EMS should be activated at this time.
What is prior to arrival in ER?
All trauma patients require this if they consume >5 alcoholic drinks/week. You do not need "permission" to order this...
What is a specified Social Work consult? (RNs CAN PLACE)
Most commonly injured abdominal organ in pediatric blunt trauma.
What is the spleen?
Included with the name of the arriving team members.
What is arrival time?
Penetrating abdominal trauma... FAST exam shows free fluid. Despite two large-bore IVs and rapid infusion, BP remains 68/40. This is the definitive management.
What is emergent surgical hemorrhage control in the operating room?
At HFGH, this is speed meets Level 2 criteria for MVCs.
What is >60 mph?
2 requirements to obtain blood products from blood bank in a trauma resuscitation.
What is patient sticker and order in GEMS?
Even for MTP or Trauma Cooler!
Name the components of the Pediatric Assessment Triad.
What is appearance, work of breathing, and circulation to skin?
A traumatic arrest is activated as a Level 1 trauma prior to arrival. This document should be used by the scribe RN.
What is the Trauma Flow Sheet?
No CPR sheet needed. All of the same info can be documented on the TFS.
Electrolyte imbalance most commonly associated with rapid infusion of PRBCs.
What is hypocalcemia?
Citrate preservative chelates calcium -> impairs cardiac contractility and coagulation.
Level 1 & 2 trauma patients have likely been injured within this timeframe.
What is the last 4 hours?
Patient arrival to antibiotic administration for open fractures has this timed goal.
What is less than 60 minutes?
Preferred site for IO access.
What is the proximal tibia?
(Physician only)
2 additional required specialties to be documented in Level 1 Trauma (in addition to Trauma & ER.)
Orthopedics & Anesthesia
Document name and time!
Other specialties upon request*
Preferred vasopressor in a patient with a C5 spinal cord injury with a BP of 82/50 and a HR of 52.
What is Levophed?
Preferred in neurogenic shock. ^ both HR and BP
Geriatric (>65) blood pressure parameter that will meet Level 1 Trauma Activation.
What is SPB <110?
Although not "activated" as a trauma and rarely involving the trauma team, patients with this injury make up approximately 40% of our annual traumatically injured patients.
What are hip fracture patients?
Preferred medications for RSI in pediatric patients.
What is ketamine or etomidate paired with sux or roc?
6 objective signs that must be documented no later than 15 mins from patient arrival.
What is temperature, heart rate, blood pressure, SpO2, respiratory rate, and GCS?
Acid-base disturbance commonly found in the early phase of hemorrhagic shock.
What is metabolic acidosis?
Tissue hypoperfusion -> anaerobic metabolism -> lactic acid production
A GCS of this, with an associated traumatic mechanism will meet Level 1 Trauma Activation.
What is ≤10?
"Lethal triad" of trauma resuscitation.