Pediatric emergency medicine trisk 0147 0147
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TABLE 7.3
PEDIATRIC TRAUMA SCORE
Category
Component
Size
+2
>20 kg (40 lb)
+1
10–20 kg
–1
<10 kg
Airway
Normal
Maintainable
Unmaintainable
Systolic blood
pressure
>90 mm Hg
50–90 mm Hg
<50 mm Hg
Central nervous Awake
system
Obtunded/loss of Coma/decerebrate
consciousness
Skeletal
Cutaneous
Closed fracture
Minor
None
None
Open/multiple fractures
Major/penetrating sum
(pediatric trauma score)
Reprinted with permission from Tepas JJ III, Ramenofsky ML, Mollitt DL, et al. The pediatric trauma score as a
predictor of injury severity: an objective assessment. J Trauma 1988;28:425–429.
RAPID ASSESSMENT
A structured approach enables the team to assess the severity of illness and injury and
to prioritize interventions. Although this rapid assessment is divided into the primary
and secondary survey, it is a continuous and dynamic process with frequent
reassessments. Any physiologic threat to the patient that is identified during this
initial assessment should be treated immediately. The order of priority is airway,
breathing, circulation, disability, exposure, and environment (ABCDE). In reality,
with a highly organized resuscitation team, activities continue in parallel, rather than
in series. If at any point in the patient’s treatment course there is unexpected
physiologic deterioration, the primary survey is rapidly repeated in order of priority
(ABCDE). Tertiary diagnostic testing, subspecialty consultation, and timely transfer
to the definitive care setting follow.
