If you look at the research generated from case review you will see that the most common injury is an extremity fracture. Vertical fall of 10 feet or greater remains as an indication for activation
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On Jun 23, 2012, at 5:35 PM, Jay Fisher <[log in to unmask]> wrote:
> Josh- Stair falls are not included in our activation algorithm at our Level
> 1 Trauma Center (Level 2 Pediatric Trauma Center). We have been recently
> surveyed by the ACS and no concerns were raised regarding this issue.
> As an anecdote, my now 17 yo daughter had just such a fall 15 1/2 years
> ago. We treated her with a bowl of ice cream. She is doing quite well - in
> fact she is so smart she is going to forgo medical school and become a
> hospital administrator!
> Jay Fisher MD FAAP
> Medical Director
> Pediatric Emergency Services
> Children's Hospital of Nevada
> Clinical Associate Professor of Pediatrics and Emergency Medicine
> University of Nevada School of Medicine
> On Sat, Jun 23, 2012 at 11:37 AM, Joshua Ross <[log in to unmask]> wrote:
>> I'm a PEM physician at an academic Level I trauma center. One of our
>> automatic activation criteria for a Level II trauma response is a "fall
>> from 10 feet or 2-3x the child's height." Our PEM group has always
>> interpreted this as a vertical fall.
>> The trauma team has expressed that this should include stair falls.
>> Meaning, a child falling 10 feet or 2-3 times his/her height down the
>> steps would trigger a Level II response (entire trauma team evaluation,
>> full immobilization,often cxr/pelvis, labs) regardless of the child's
>> clinical appearance.
>> Our PEM group feels this would overtriage patients and the injury severity
>> and pattern of stair falls are not equivalent to vertical falls.
>> My question for other Level I trauma centers: In your institution how is
>> the mechanism of stair falls addressed in your leveling criteria?
>> Thanks for your input,
>> Josh Ross
>> Pediatric Emergency Medicine
>> University of Wisconsin College of Medicine and Public Health
>> American Family Children's Hospital
>> For more information, send mail to [log in to unmask] with the
>> message: info PED-EM-L
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> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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