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Trauma Patient Admission Criteria

Trauma patients can be complex with multiple injuries requiring various management strategies, interventions, and care. As a result, determining the appropriate level of care for admission can be challenging. The following represents a list of criteria/conditions that may help guide level of care decision making for the trauma patient. 

ICU ADMISSION

  • Grade IV or greater solid organ injury or Grade III injury with blush/active extravasation 
  • Any hemodynamic instability
  • Base deficit >6
  • Pelvic fractures requiring blood transfusion or IR angiogram/embolization
  • Any spine fracture with neurologic deficit 
  • Mandible fracture with edema or hematoma 
  • Traumatic brain injury with GCS<13
  • Patient >55 yrs of age, on anticoagulation with abnormal CT head
  • Risk of airway compromise
  • High risk rib fracture patient with FRC<1000mL
  • Presence of pulmonary co-morbidities 
  • Blunt myocardial injury with new
      • arrythmia
      • hemodynamic instability
      • cardiac failure
  • Unstable spine injury
  • Frontal contusions >2cm
  • Solid organ/pelvis/abdominal injuries with evidence of active extravasation on CT scan
  • need for q1hr vital signs/neuro-vascular checks/interventions/etc. 
  • Trauma attending discretion

SDCC Admission

  • Grade II/III solid organ injury without blush/active extravasation on CT
  • presence of multiple injuries 
  • Rib fractures with FRC between 1000mL--1500mL
  • Any patient on pre-injury anticoagulation therapy with an injury not requiring ICU
  • Major soft tissue trauma in patients on anticoagulation therapy 
  • Need for q2hr vital signs/neuro-vascular checks/interventions/etc. 
  • Presence of multiple co-morbidities
  • Age > 70
  • C-spine fractures exclusive of spinous and transverse process fractures (without neurologic injury) 
  • History of sleep apnea who needs narcotics 
  • New CPAP/BiPAP requirements
  • Trauma attending discretion 

FLOOR Admission

  • all other trauma patients who do not meet criteria for ICU or SDCC admission 
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