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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?

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On Jun 23, 2012, at 5:52 PM, "Joshua Ross" <[log in to unmask]> wrote:

> Colleagues,
> 
> 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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