Reasons for Transfer to a Pediatric Trauma Center
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- Any seriously ill or injured child who cannot be managed in the community hospital
- Trauma – any of the following:
- Multiple-system injury (two or more organ systems)
- Penetrating wounds to head, neck, chest, abdomen, back, groin, extremity above the knee or elbow
- Cardiac or major vessel injury
- Massive maxillofacial trauma
- Spinal injury with deficit
- Severe head injury:
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- Glasgow Coma Scale score (GCS) less than or equal to 12
- Deteriorating GCS regardless of score – Penetrating or open injury
- Depressed skull fracture – CSF leak – otorrhea or rhinorrhea
- Focal or lateralizing signs, i.e. posturing
- Intracranial hemorrhage
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- Abdominal injury, blunt, with tenderness
- Falls greater than 10 feet or 2-3 times the height of the child
- High-risk auto crash
- – Passenger space intrusion > 12 inches where trauma victim is sitting OR any occupant in a passenger seat when there is > 18 inches intrusion at any site within the passenger space
- – Ejection from automobile
- – Person who is in same passenger compartment in which a trauma death has occurred
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- Auto versus pedestrian / bicyclist who is thrown any distance, run over or with significant (> 20 mph) impact
- Motorcycle crash including “laying bike down,” > 20 mph
- Single-system injury that cannot be managed by the community hospital
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