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