TRAUMA SERVICE CONSULTATION GUIDELINE:
INJURY WARRANTS TRAUMA EVALUATION1 or RECOGNIZED NEED FOR TRAUMA SERVICE ADMISSION2à CALL SGT IMMEDIATELY
· Trauma service consultation does NOT represent completed transition of care
· Trauma admission order represents transition of care, unless workup ongoing OR admission order entered at time of consultation, which will be directly communicated between trauma and emergency resident
INJURY WARRANTS TRAUMA EVALUATION1:
· Documented or concern for:
o solid organ injury
o hollow viscous injury
o bladder or kidney injury (includes gross hematuria)
o vascular injury (includes ischemic limb, abnormal API, documented injury on imaging)
§ See Extremity Vascular Injury guideline
o cardiac or pulmonary injury
o rib fracture
o pneumothorax or hemothorax
o complex wound without underlying fracture or open joint
o mangled extremity
§ See Mangled Extremity guideline
o compartment syndrome without underlying fracture
o penetrating thoracic injury with pleural violation
o penetrating abdominal or pelvic injury with peritoneal violation
INJURY WARRANTS TRAUMA ADMISSION2:
· Multisystem (“polytrauma”)
o Multiple service line involvement
o Multiple injuries not covered by the same surgical specialist
o Any individual injury requires trauma service management
· High-mechanism fracture at risk of additional injury
o See attached Fracture Admission Guideline for high-risk injuries
· Low-mechanism fracture with additional injuries or multiple fractures
o See attached Fracture Admission Guideline for special considerations
DIRECT SERVICE CONSULTATION (in lieu of or in addition to SGT consultation):
· Ortho: extremity fracture, compartment syndrome with associated fracture, pelvic fracture
· Hand (Ortho, PLA): distal upper extremity fracture, compartment syndrome, soft tissue, tendon or nerve injury
· Neurosurgery: traumatic brain injury with altered mental status (GCS<8), BIG 3
· Spine: spine fracture other than processes
· Maxillofacial Trauma (OMFS, PLA, ENT): facial fracture, facial laceration
· Ophthalmology: globe rupture, elevated intraocular pressure, need for lateral canthotomy
è NO direct Interventional Radiology, Urologic, Cardiac, Thoracic or Vascular service consultation unless requested by SGT based on need for urgency of communication
Posted Nov 2020; Reviewed Jan 2023
