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Trauma Triage Criteria -Adult and Pediatric


 
 
 

TRAUMA ACTIVATION CRITERIA 

Leveling criteria are guidelines only.  Leveling should be guided by the

rationale for each level and by clinical judgment. 


FULL TEAM

Patient unstable - Need for immediate trauma resuscitation or immediate OR

Team includes:  Trauma Surgeon, ED MD, Anesthesia, ED RNs, ICU RN, Lab, Xray, CT Tech, Respiratory, Pharmacy, Scribe, House Supervisor, Social Services, Admissions

 
Airway & Breathing
  • Intubated patients
  • Threatened or compromised airway
  • Pneumothorax or ventilation compromise
  • Grunting or stridor in child
  • Respiratory rate < 10 or > 29 (< 20 infant < 1 yr)
  • Flail chest
 

Circulation

  • Systolic blood pressure <90
  • Transfer patients receiving blood to maintain vital signs
 

Disability

  • GCS < 12
  • Open or depressed skull fracture
  • Paralysis or focal neurologic deficit
 
Mechanism of Injury
  • Burns >20% BSA or to head, face, genitalia
  • High voltage injury (including lightening) 
  • Penetrating injury to torso, neck, head,

            or proximal to elbow or knee   
     

    Other

    • Unstable pelvic fracture
    • Bilateral femur fractures
    • Open fractures in multiple trauma setting
    • Pulseless extremity / threatened limb
    • Traumatic amputation / mangled limb / crushed / degloved / impaled
    • MD or RN discretion
PARTIAL TEAM

Patient stable – Mechanism suggests possible significant injury – need expedited evaluation

Team includes:  ED MD, ED RN, Lab, X-ray, Admissions

 
Injuries Found
  • Isolated open fractures
  • 2 or more proximal long bone fractures

             (bilateral femur fractures = Full Team)

  • Subcutaneous emphysema
  • Possible spinal fractures without CNS

             involvement

  • Maxillofacial trauma without airway                

            compromise 

Mechanism of Injury

    • Auto vs pedestrian / bicycle
  • Death in same collision
  • Thrown from horse
  • MVC w/speed �� 45 MPH
  • Motorcycle / ATV / snowmobile crash
    • Fall > 15 feet

                  Pediatric falls > twice their height

               

 
Consider Activation for High Risk Patients:
    • Age > 65 or < 5
    • Multiple co-morbidities
    • Blood thinners or other bleeding/clotting disorders
    • Ejection from vehicle / rollover
    • Major auto deformity, intrusion into occupant compartment > 12 inches
    • Extrication > 20 minutes
    • Pregnancy > 20 wks
    • Hypo or hyperthermic symptoms
 

Other

    • Stable transfers from outside hospital ED with injuries resulting from traumatic mechanism

       (ED to ED or in-patient < 24 hours)


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