Pediatric Trauma

Triage & Transport

 

Patient ≤ 16 years old?

 

  • No
    • Follow Adult Trauma Triage and Transport Guidelines!
  • Yes

 

    • Inability to manage or secure airway/oxygenation/ventilation?
    • Unmanageable signs/symptoms of shock?
    • Uncontrolled bleeding?

 

  • Yes
    • Transport to GMMC. (Pediatric Trauma Center)

 

  • No

 

    • Pediatric Glasgow Coma Scale PGCS ≤ 13
    • Decreased Level of Responsiveness (See AVPU Scale)
    • Penetrating trauma to head, neck, torso, or extremities proximal to knee or elbow
    • Proximal Long Bone Fractures - crushed, mangled, or degloved extremity - Amputation proximal to the wrist or ankle - Pelvic Fractures
    • Open or depressed skull fractures
    • Indications of significant closed head injury
    • Paralysis
    • Ejection of patient
    • Indications of significant chest or abdominal trauma
    • Auto vs. Pedestrian > 20 mph

 

  • Yes
    • Transport to GMMC if within 60 minutes by ground

 

  • No
    • ( if greater than 60 minutes)
    • Transport to Closest Trauma Center

 

  • No

 

    • Fall > 10 feet or 2-3 times the height of a child
    • MVA with Intrusion > 12 inches roof, 18 inches of the passenger compartment (as outlined in 2011 CDC guideline)
    • Ejection from the vehicle (other occupant)
    • Death in the same vehicle
    • Mechanism consistent with high risk of injury
    • Inadequately restrained
    • Another occupant of the same vehicle is transported to a high level trauma center
    • Auto vs. Pedestrian < 20 mph
    • Motorcycle or motorized recreational vehicle.

 

  • YES
    • Transport to GMMC, if within 30 minutes by ground

 

    • if not within 30 minutes by ground then Transport to the closet Trauma Center
  • No
    • Special Circumstances
      • Burns
      • Pregnancy > 20 Weeks

 

    • Without other trauma mechanism: triage to appropriate facility
    • With trauma mechanism: triage to trauma center

 

Any injury not mentioned above shall be triaged and transported based on the EMS provider judgment - preferably with online medical direction - and according to local Protocols.