Print

Print


The same issue (Trauma activation) has come up at our level 1 trauma center.
We do not equate height of stairs with a direct vertical fall of the same height. They obviously are not the same as the stairs do dissipate some energy (converting the the potential energy of a fall from a height to rotational and frictional energy as well as kinetic energy.) It is the pure kinetic energy of a fall that causes the trauma as the falling object stops abruptly! From my prior life as a physicist. 
We rely on other factors and criteria in these type of injuries! 
Chuck

  

 
Dr. Charles Nozicka 
Medical Director 
Pediatric Emergency Medicine
Advocate Condell Medical Center
Clinical Associate Professor of Emergency Medicine
Rosalind Franklin University
Libertyville, Illinois



"A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves."- Lao-Tzu
 



 



-----Original Message-----
From: james reingold <[log in to unmask]>
To: PED-EM-L <[log in to unmask]>
Sent: Sun, Jun 24, 2012 6:07 pm
Subject: Re: stair falls leveling criteria


I've never heard of that before despite having worked at a few Level 1 trauma 
enters.  I will tell you from experience that falling down the full flight of 
tairs seems a lot milder than falling out the window even if the total height 
s the same.  I feel like I've seen more skull fractures from falling off the 
itchen counter.
ames
 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 
hild based on the physical findings at triage, your trauma team view looks to 
e like an over response, and I wonder how often did those multi protocol 
enerated 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:
 
 > Colleagues,
 > 
 > I'm a PEM physician at an academic Level I trauma center.  One of our 
utomatic activation criteria for a Level II trauma response is a "fall from 10 
eet or 2-3x the child's height."  Our PEM group has always interpreted this as 
 vertical fall. 
 > 
 > The trauma team has expressed that this should include stair falls.  
eaning, a child falling 10 feet or 2-3 times his/her height down the steps 
ould trigger a Level II response (entire trauma team evaluation, full 
mmobilization,often cxr/pelvis, labs) regardless of the child's clinical 
ppearance.  
 > 
 > Our PEM group feels this would overtriage patients and the injury severity 
nd pattern of stair falls are not equivalent to vertical falls.
 > My question for other Level I trauma centers:  In your institution how is 
he 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 
essage: info PED-EM-L
 > The URL for the PED-EM-L Web Page is:
 >                 http://listserv.brown.edu/ped-em-l.html
 
 
 
 ______________________________________________________________________
 This e-mail has been scanned by McAfee Managed Email Content Service.  To 
eport
 any issues regarding e-mail SPAM ONLY, please call the Helpdesk at
 718-283-MIS1________________________________________________
 
 For more information, send mail to [log in to unmask] with the 
essage: info PED-EM-L
 The URL for the PED-EM-L Web Page is:
                  http://listserv.brown.edu/ped-em-l.html
		 	   		  
or more information, send mail to [log in to unmask] with the message: 
nfo PED-EM-L
he URL for the PED-EM-L Web Page is:
                http://listserv.brown.edu/ped-em-l.html


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:
                 http://listserv.brown.edu/ped-em-l.html