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,
Pediatric Emergency Medicine
University of Wisconsin College of Medicine and Public Health
American Family Children's Hospital
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