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