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COMBINED FAMILY ADULT & PEDIATRIC TRAUMA (Mixed Bundles)

These pages are excerpted from the Trauma Resident Handbook, Rhode Island Hospital Department of Surgery, Division of Trauma - updated 2001. The policies herein are intended to serve as guidelines only. Individual circumstances need to be considered as there may be times when it is appropriate or desirable to deviate from these guidelines. These educational guidelines will be reviewed and updated routinely.

The goal of this policy is to have pediatric trauma managed at Hasbro and adult trauma managed in the Bridge ER. The policy for adult/child trauma is as follows:

In the case of adult/child trauma arriving in the Davol ED:

  1. It is the responsibility of the ED Attending at Davol to assess the ABCs of the child. If there are no airway or hemodynamic problems, the Hasbro ED will be notified immediately and the child will be transported to Hasbro while still on the ambulance stretcher. No Davol chart will be generated. The child will be accompanied by an ED resident. Upon arrival at the Hasbro ED, the ED resident will document on the ED Face Sheet that the child was evaluated and found to have an intact airway, adequate breathing, and hemodynamic stability, and was transported with or without incident.
  2. If the child is evaluated by the ED Attending at Davol and found to have an airway or breathing problem, or appears to be hemodynamically unstable, the child will be put in a trauma bay in Davol ED and the pediatric surgical trauma team and the Hasbro ED Attending/Fellow will be notified that the patient is located in the Davol ED. The child will be admitted to the Davol ED and a chart will be generated in the Davol ED.

In case of adult/child trauma arriving in the Hasbro ED:

  1. If an adult/child trauma arrives at the Hasbro ED, it will be the responsibility of the Hasbro ED Attending/Fellow to assess the ABCs of the adult. If the adult has no airway or breathing problems or hemodynamic instability, the Davol ED will be notified immediately and the adult will be transported while still on the rescue stretcher to the Davol ED by the ED or pediatric resident. Upon arrival at the Davol ED, the resident will document on the ED Face Sheet that the patient was evaluated and found to have no airway or breathing problem or hemodynamic instability and was transported with or without incident to Davol ED, as the case indicates.
  2. In the case of an adult trauma patient who is hemodynamically unstable or has an airway or breathing problem, the adult will be evaluated by the ED Attending/Fellow and admitted to the Hasbro ED. The Trauma Team and the Davol ED Attending will be notified that the patient is in the Hasbro ED and a chart will be generated through the Hasbro ED.

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