Pediatric Trauma Management

. C-spine immobilization as indicated. Basic . Place patient in trendelenburg position if indicated. . Airway management. . Assist breathing if necessary with high flow oxygen. Ventilate patient at a rate Orde between 8-12 breaths per min. . Control severe bleeding. rs . Refer to Broselow tape for guidance. The trauma patient should be managed in the most effective but expeditious manner possible. Our goal should be to have a scene time of less than 10 minutes if possible. Prehospital care should include thorough assessment, evaluation, and life-saving treatment of the patient without delay in transport.

. IV Access with NS, 2 large bore IV catheters. If IV access will be longer than 90 Adv seconds to obtain, consider IO if no contraindications are present. . Fluid therapy 20 ml/kg bolus for hypotension. Titrate to keep systolic blood anc pressure greater than or =90mmHg. Refer to appropriate vital sign table ed . Attach cardiac monitor and obtain Lead II EKG tracing for documentation. . If traumatic arrest: consider bilateral chest needle decompression if signs EM indicate pneumothorax (Medics only). . Musculoskeletal trauma: Refer to pain management protocol (Medics T & only.) . Consider patient as a candidate for air transport. Air transport should be Par utilized whenever patient care can be improved by decreasing transport time or by giving advanced care.

am . Patient transport via ground ambulance should not be delayed to wait for the helicopter. If the patient is packaged and ready for transport and the edi helicopter is not on the ground or within a reasonable distance, then ground transport should be initiated.

c . If scene conditions or the patient’s condition improves after activation of air transport and air transport is no longer deemed necessary, then the Ord paramedic on the scene may cancel the request for air transport. . Minimal information which should be provided to EMS Dispatch for ers relaying to the air medical transport service should include: a. Number of patient(s) d. Mechanism of injury b. Age of patient(s) e. Estimated patient weight c. Sex of patient(s) Pediatric Trauma Score Sheet Assessment +2 +1 -1 Score Weight Greater than 10 to 20 kgs. Less then 10 20 kgs. (44 (22 to 44 lbs.) kgs. (less then lbs.) 22 lbs.) Airway Airway is Airway is Airway is not patent with no maintainable maintainable, assistance and protected requires required. by patient, adjunct therapy monitoring such as required. suctioning, OPA or intubation. Systolic B/P & Systolic B/P is Systolic B/P is Systolic B/P is Pulses** greater then 90 between 50-90 less then 50 mmHg with mmHg with mmHg with no palpable radial palpable carotidpalpable pulse. pulse. pulse. CNS Awake and Positive LOC Unresponsive Alert. (may have been temporary). Fractures None Suspected or Multiple closed fractures either fractures. open or closed. Wounds None Minor wounds Penetrating, (abrasions, major lacerations or avulsions, burns that lacerations, cover less then burns that 10% of the body cover greater that do not then 10% or include burns ofburns involving the hands, face, the hands, face, feet or feet of genitalia. genitalia). Total Score

Pediatric Trauma Scoring System: 9-12 – Minor trauma 6-8 – Potentially life threatening trauma 0-5 – Clearly a life threatening trauma Less than 0 – Usually a fatal injury

**If a proper sized blood pressure cuff is not available, blood pressure can be rated as:

+2= palpable at wrist +1= palpable at groin -1=no palpable pulse