“Not every pediatric trauma patient falls neatly into a category in a local trauma triage protocol,” said Jennifer Fishe, MD. During an interactive session exploring destination dilemmas in pediatric trauma transport on Friday, Feb. 26 at EMS Today 2016 in Baltimore, Md., a panel of prehospital professionals discussed and learned how to interpret triage protocols.
The expert panel consisted of Dr. Fishe, Dr. Jennifer Anders, Dr. Kathleen Brown and Dr. Joelle Simpson, pediatric emergency medicine physicians at The Johns Hopkins Hospital and Children’s National Medical Center. The panelists, all of whom have experience in pediatric prehospital research and/or medical direction, created the session after reviewing cases with paramedics in which children did not clearly fit into trauma triage protocol criteria.
“For example,” said Dr. Anders, “where do you transport a child who fell off the monkey bars and has an obvious elbow deformity, but otherwise doesn’t meet criteria to go to a trauma center?” Not all hospitals have pediatric orthopedics to properly care for pediatric elbow fractures. A hotly debated topic at the session was the scenario of a toddler who fell from standing and hit their head without losing consciousness. While this may seem like a routine transport to a local facility, this child had multiple chronic medical problems, a gastrostomy tube, and a shunt in their head.
Session attendees received handouts explaining the origins of pediatric trauma protocols and samples of different protocols from across North America, highlighting differences in transport decision-making. Highlights from the session included:
- An audience participation session in which paramedics were introduced to colleagues from other regions
- A review of the National Pediatric Readiness Project and how to interpret future hospitals’ pediatric designations
- Comparing differences from North American regional and local pediatric protocols
- Group discussions on 11 different pediatric destination dilemma cases
- An open Q&A session with the expert panel
For more coverage of EMS Today 2016, click here.