Pediatric Presence at Pediatric Trauma Activations

Purpose:

The trauma service frequently encounters critically injured pediatric patients that require pediatric specific resuscitation measures. To optimize patient outcomes and experiences, assistance in the initial resuscitation and care of these critically injured pediatric trauma patients is often enhanced by the presence and involvement of pediatric nursing and/or pediatric critical care provider. The following guidelines outline when pediatric nursing and providers will be present at pediatric trauma activations.

Criteria for Pediatric Presence at Pediatric Trauma Activations:

• When available, the pediatric critical care provider (APP and/or attending) will present to all FULL trauma activations in patients age 12 years and younger.
• For LIMITED activations or other pediatric trauma encounters in the ED, the presence of the pediatric critical care provider (APP and/or attending) may be requested on an as needed basis.
  • • • • The pediatric ICU APP may be contacted via PerfectServe (Pediatric Critical Care Medicine Academic Service TNMC) or by paging 402-888-7226.

• The presence of the pediatric ICU (PICU)/pediatric lead nurse (or designee) may be requested for any pediatric trauma activation/encounter in the ED when pediatric specific skill set felt to be beneficial to case.
  • • • • The PICU/Pediatric Lead Nurse may be contacted via Volte phone at 531-557-3201. 

***Due to staffing and responsibilities in the pediatric ICU, the pediatric critical care provider and pediatric ICU lead nurse (or designee) may not always be immediately available to respond in person to activations. If the pediatric critical care provider and/or nurse are not present at a pediatric trauma activation and presence is needed, please contact at above listed numbers.***

Responsibilities:

Responsibilities and involvement of pediatric nursing and pediatric critical care provider during the initial trauma resuscitation will be in collaboration with the trauma team and at the discretion of the trauma attending. Responsibilities include, but are not limited to, the following:

• Pediatric Nurse:
  • • • • Assist in obtaining IV access
        • Assist in nursing procedures (NG, OG, foley placement, etc)
        • Assist in administration and titration of medications or IV fluids
        • Assist in transfusion of blood products

• Pediatric Critical Care Provider:
  • • • • Assistance with procedures (central lines, arterial lines, chest tubes, etc)
        • Assistance with medication selection and dosage (in collaboration with pharmacy)
        • Coordination and assistance with fluid and blood product resuscitation (in conjunction with trauma team)
        • Assistance with ventilator management
        • assistance in consultation of pediatric subspecialties