"Ten one-foot falls does not equal one ten-foot fall."
On Jun 24, 2012, at 6:00 PM, james reingold <[log in to unmask]> wrote:
> I've never heard of that before despite having worked at a few Level 1 trauma centers. I will tell you from experience that falling down the full flight of stairs seems a lot milder than falling out the window even if the total height is the same. I feel like I've seen more skull fractures from falling off the kitchen counter.
>> Date: Sun, 24 Jun 2012 03:08:08 +0000
>> From: [log in to unmask]
>> Subject: Re: stair falls leveling criteria
>> To: [log in to unmask]
>> We have never consider stairs fall as a vertical fall, and would treat the child based on the physical findings at triage, your trauma team view looks to me like an over response, and I wonder how often did those multi protocol generated tests result in change of care... How about using clinical judgement?
>> Sent from my iPad
>> On Jun 23, 2012, at 5:52 PM, "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
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