Time Critical Guidelines: Trauma (Paediatric)
 
 
 
 
In Setting of Trauma
                  
Are VS's abnormal?                  
                     
Assess for Vital Signs No              
Are there any of the following?
     
 
Newborn
<2 weeks
Infant
<1 year
GCS:
<15
<15
Heart Rate:
<100 or 170
<90 or >170
Resp Rate:
<40 or >60
<20 or >50
BP:
N/A
<60mmHg
SPO2:
N/A
<90%
Skin: cold /pale /clammy cold /pale /clammy
     
 
Child
1-8 years
Large Child
9-15 years
GCS:
<15
<15
Heart Rate:
<75 or >130
<65 or >100
Resp Rate:
<20 or >35
<15 or >25
BP:
<70mmHg mmHg
<80mmHg
SPO2:
N/A
<90%
Skin: cold /pale /clammy cold /pale /clammy
               
                 
             
             
             
           
           
             
 
 
 
 
 
 
 
 
 
 
 
 
  Yes No                
Major Trauma            
Vital Signs NOT normal            
                     
Actually Time Critical
         
                     
Action at per appropriate CPG            
Consider MICA / Aeromedical support            
Triage to highest level of trauma service within 30min                
                         
                         
     
Vital Signs are normal...
           
      but is there a Mechanism of Injury?            
                     
      Assess for Pattern of Injury  
No Pattern of Injury...
      
      Are there any of the following:

Penetrating Injuries
- Head / Neck / Chest / Abdomen / Pelvis / Axilla / Groin

Blunt Injuries
- Significant injury to a single region:
Head / Neck / Chest / Abdomen / Axilla / Groin
- Injuries involving two or more of the above body regions

Specific Injuries
- Limb amputations / limb threatening injuries
- Suspected spinal cord injury
- Burns >20% or involving respiratory tract
- Serious crush injury
- Major compound fracture or open dislocation
- Fracture to two or more of the following:
Femur / Tibia / Humerus
- Fractured pelvis		 No and Vital Signs are normal, but is there a Mechanism of Injury?      
                 
        Assess for Mechanism of Injury      
        Are there any of the following:

- Ejection from vehicle
- Motor/cyclist impact > 30kph
- Fall from height > 3m
- Struck on head by falling object > 3m
- Explosion
- High speed MCA > 60kph
- Vehicle rollover
- Fatality in same vehicle
- Pedestrian impact
- Prolonged extrication >30min		 No    
   
   
   
   
   
   
   
   
   
          Yes      
        Yes            
      Significant Pattern of Injury   Positive MOI and Co-morbidities  
No MOI
      • Vital Signs normal   • Vital Signs are normal
• No Pattern of Injury		   • Vital Signs are normal
• No Pattern of Injury
                     
   
Emergent Time Critical
 
Potentially Time Critical
 
Not Time Critical
                     
      Action at per appropriate CPG   Action at per appropriate CPG   Action at per appropriate CPG
      Consider MICA / Aeromedical support   Triage to highest level of trauma service within 30min   Triage to nearest appropriate facility if required
      Triage to highest level of trauma service within 30min