Your go-to reference for all things pediatric trauma.
Quick Access
📋
Decision Guide
Should I Trauma Chart?
A step-by-step decision guide to determine if trauma charting is required.
Quick Reference~1 min
✔️
Checklist
Trauma Documentation — What Did I Miss?
A checklist to verify your trauma charting is complete.
Quick Reference~2 min
🩸
Updated
MTP and Belmont Rapid Infuser
Step-by-step MTP process and Belmont helpful reminders.
ProtocolRevised Mar 2025
Trauma Documentation — What Did I Miss?
Charting Completeness Checklist
Mark each item yes or no. All items should be Yes before closing your chart.
Should I Trauma Chart?
Step-by-Step Decision Guide
1
Step 1 of 1
Did any of the following apply to this patient?
The patient sustained an injury in the last 14 days and has at least one of the following:
• They were transferred in from another facility
• They were transferred out to another facility
• They were admitted or going to be admitted
• They were evaluated by a surgical specialty (General Surgery, Neurosurgery, Orthopedic Surgery, etc.)
• They died as a result of their injury
✅
Trauma Charting Required
Based on your answers, this patient meets criteria for trauma charting. Please complete a trauma chart for this patient.
🚫
Trauma Charting Not Required
Based on your answers, this patient does not meet criteria for trauma charting at this time.
MTP & Belmont Rapid Infuser
Step-by-Step Guide & Helpful Reminders
🩸 MTP Process
1
Call Blood Bank
Call Blood Bank at 4-2308 and notify them: "The Massive Transfusion Protocol is being initiated."
Provide the following:
a. Patient name
b. Weight
c. Medical Record Number
d. Location (ER)
ImmediatePhone call
2
Place Order in EPIC
Place the order within EPIC using the "Massive Transfusion Protocol" order set.
EPIC Order Set
3
Complete Paper MTP Form
Fill out the paper MTP form in its entirety and keep it at the bedside throughout the resuscitation.
Paper Form
4
Send a Runner to Blood Bank
Designate a team member to run to Blood Bank and pick up the blood products. Do not use the pneumatic tube for blood products.
Assign immediately
⚡ Belmont Rapid Infuser — Helpful Reminders
⚠️ No Extensions or PRN Connectors
Do NOT use any IV extensions (pigtails) or PRN connectors (microclave needleless connectors). Connect the Belmont directly to the IV hub.
💉 IV Size Matters
The larger the IV, the greater the flow rate you will be able to achieve.
🔔 Pressure Control Alarm
If the Belmont alarms for pressure control, press the "Set Rate" button to match the actual rate — this allows the Belmont to administer at the rate it can.
🚫 No Pre-Warmed Fluids
Do not use pre-warmed fluids — this may create an opportunity to overheat and cause injury to the patient.
🩸 Blood & Saline Only
Blood and saline should really be the only fluids on the Belmont — but if someone is bleeding internally or externally, they need blood, not pasta water.
Education
CME/CNE Educational Opportunities
🏥
2026 Dates
Pediatric Trauma Case Conference
View all 2026 conference dates for the Pediatric Trauma Case Conference.
CME/CNEBimonthly
🎬
Video Series
10-Minute Trauma Talks
Pediatric Trauma Video Education Series. All videos are 10 minutes or less.
Video Education⏱ ≤ 10 min each
10-Minute Trauma Talks
Pediatric Trauma Video Education Series
⏱
All videos in this series are 10 minutes or less — designed for quick learning between patients.
Pediatric Burns — Fluid Resuscitation
⏱ 6 min 30 sec · Pediatric Trauma Talk
Pediatric Trauma Case Conference
2026 Conference Dates
All conferences are held bimonthly. Mark your calendar and plan ahead for CME/CNE credit.
💻
Virtual and in-person options are available for all conferences.
January 15, 2026
Thursday
⏰ 0700 – 0800
March 19, 2026
Thursday
⏰ 0700 – 0800
May 21, 2026
Thursday
⏰ 0700 – 0800
July 16, 2026
Thursday
⏰ 0700 – 0800
September 17, 2026
Thursday
⏰ 0700 – 0800
November 19, 2026
Thursday
⏰ 0700 – 0800
Protocols
Algorithms & Clinical Practice Guidelines
All
Resuscitation
Burns
🩸
Updated
MTP and Belmont Rapid Infuser
Step-by-step MTP process and Belmont Rapid Infuser helpful reminders.
ResuscitationRevised Mar 2025
🚨
Protocol
Trauma Activation Criteria
Level I, II, and III activation thresholds with team notification tree.
ResuscitationCurrent
🔥
Protocol
Pediatric Burns Protocol
Step-by-step burn algorithm and decision to transfer.
BurnsCurrent
MTP & Belmont Rapid Infuser
Step-by-Step Guide & Helpful Reminders
🩸 MTP Process
1
Call Blood Bank
Call Blood Bank at 4-2308 and notify them: "The Massive Transfusion Protocol is being initiated."
Provide the following:
a. Patient name b. Weight c. Medical Record Number d. Location (ER)
ImmediatePhone call
2
Place Order in EPIC
Place the order within EPIC using the "Massive Transfusion Protocol" order set.
EPIC Order Set
3
Complete Paper MTP Form
Fill out the paper MTP form in its entirety and keep it at the bedside throughout the resuscitation.
Paper Form
4
Send a Runner to Blood Bank
Designate a team member to run to Blood Bank and pick up the blood products. Do not use the pneumatic tube for blood products.
Assign immediately
⚡ Belmont Rapid Infuser — Helpful Reminders
⚠️ No Extensions or PRN Connectors
Do NOT use any IV extensions (pigtails) or PRN connectors (microclave needleless connectors). Connect the Belmont directly to the IV hub.
💉 IV Size Matters
The larger the IV, the greater the flow rate you will be able to achieve.
🔔 Pressure Control Alarm
If the Belmont alarms for pressure control, press the "Set Rate" button to match the actual rate — this allows the Belmont to administer at the rate it can.
🚫 No Pre-Warmed Fluids
Do not use pre-warmed fluids — this may create an opportunity to overheat and cause injury to the patient.
🩸 Blood & Saline Only
Blood and saline should really be the only fluids on the Belmont — but if someone is bleeding internally or externally, they need blood, not pasta water.
Trauma Activation
Activation Criteria
📌
NoteThese are guidelines and any patient may be designated a Level I trauma patient at the discretion of the treating physician.
🚨 Level I — Full Activation
1.1 Traumatic arrest in the field 1.2 Intubated in the field 1.3 Suspected airway compromise — including severe facial burns / inhalation injury 1.4 Traumatic respiratory compromise (*transfer-in from OSH) 1.5 Hypotension (Age Specific):
0–1 month: <60 systolic
1 month – 1 year: <70 systolic
1–10 years: <70 + (2 × age in yrs) systolic
Over 10 years: <90 systolic
1.6 Received >20 mL/kg bolus crystalloid in the field 1.7 GCS <9 with traumatic MOI 1.8 Paralysis or suspected spinal cord injury 1.10 Amputation or near amputation proximal to the wrist or elbow 1.11 Pulseless extremity 1.13 Burn 2nd degree or greater >30% TBSA 1.14 ED discretion 1.15 Penetrating trauma to head / neck / trunk / groin 1.16 Need for continued blood transfusion (*transfer-in from OSH)
📌
NoteA Level II trauma patient may be upgraded or downgraded in status at the discretion of the treating physician.
⚡ Level II — Partial Activation
2.4 Burn 2nd degree or greater 10–30% TBSA 2.6 Femur fracture with MVC / Auto vs. Pedestrian 2.11 ED discretion 2.12 Pregnancy >20 weeks with major traumatic mechanism 2.14 Suspected or known pelvic fracture(s) 2.15 Traumatic Brain Injury (TBI) GCS 9–12 2.16 Tourniquet in place
📋 Level III — ED Consult
3.4 Suspected child maltreatment 3.6 Burn 2nd degree or greater <10% TBSA (warranting admission) 3.7 ED discretion 3.8 Penetrating extremity trauma with significant injury 3.10 Suspected abdominal injury (pain, seatbelt sign, and/or bruising) 3.11 Fall >10 ft or 3× the patient's height 3.12 Auto vs. pedestrian with significant impact 3.13 Traumatic Brain Injury (TBI) GCS 13–15:
With intracranial injury or skull fracture unable to discharge home — call Neurosurgery
Concussion without intracranial bleed unable to discharge home — call Hospitalist
3.14 Orthopedic injury requiring reduction / surgical repair (does not require trauma surgeon notification) 3.15 Asymptomatic air / pellet gun injuries 3.16 Motorized vehicle ejection — to include ATV / motorcycle ejection / separation
Pediatric Burns Protocol
ABLS™ — Initial Assessment & Management
Primary Survey: A — E
Assess and manage life-and-limb threatening conditions
A
Airway maintenance & c-spine protection
Maintain in-line cervical immobilization (if required based on mechanism or other findings)
B
Breathing and ventilation
1. Assess rate, depth, and quality
2. Consider O2 via NRB / Intubation vs. BVM
3. Difficulty ventilating: torso burns, ETT placement, inhalation injury, and suction
C
Circulation & hemorrhage control
Cardiac status / monitor
1. Burns do not bleed — identify and treat
2. Assess peripheral perfusion
3. Identify circumferential burns
4. Initiate v/s monitoring
5. IV — Large bore, start LR for >20% TBSA
Initial IV Fluid Rate
≤5 years old @ 125 mL/hr
6–13 years old @ 250 mL/hr
≥14 years old @ 500 mL/hr
D
Disability
Neurological Deficit · Gross Deformity
1. Assess LOC using AVPU
2. Obtain a POC blood sugar if needed
3. Identify any gross deformity / serious injuries
E
Exposure / Examine
Environment Control
1. Stop the burning process
2. Remove all articles of clothing / jewelry
3. Log roll patient: check posterior surfaces
4. Keep patient warm
Transfer Criteria
1. TBSA ≥5% (partial / full thickness)
2. Any % burn to the face, hands, feet, genitals, joints, or perineum
MEDCOM Transfer Process
1. Contact MEDCOM @ 210-233-5815 within 30 mins of arrival
2. Complete MEDCOM form and fax to 210-233-5822
3. Arrange transport within 2 hours of arrival
Revised 01/2026
PI Dashboard
Performance Improvement · CY2026
📊 Key Quality Metrics
Nursing Documentation
Target: 80%
82%
✓ Above target
Blunt Trauma Imaging
Target: 80%
91%
✓ Above target
Burns
Target: 80%
85%
✓ Above target
Abdominal Injury
Target: 80%
87%
✓ Above target
Orthopedic Injury
Target: 80%
72%
⚠ Below target
Spinal Cord Injury
Target: 80%
100%
✓ Above target
Traumatic Brain Injury (TBI)
Target: 80%
85%
✓ Above target
Thoracic Injury
Target: 80%
100%
✓ Above target
Massive Transfusion Protocol (MTP)
Target: 80%
37%
⚠ Below target
Child Maltreatment
Target: 80%
87%
✓ Above target
Non-Surgical Admissions
Target: <10%
3%
✓ Below target
📁 Volume & Case Mix — CY2026
Total Trauma Activations (YTD)
4
Total Trauma Patients (YTD)
84
Falls
Highest mechanism
87%
Patients ≤14 Years Old
88%
Patients ≥15 Years Old
12%
Admissions
37%
Discharged Home or Transferred
63%
Primary Admission Service
Orthopedic — highest YTD
55%
Reference
Calculators & Quick Reference
⚖️ Pounds to Kilograms Converter
Kilograms (kg)
—
Rounded (kg)
—
Enter weight in pounds to convert
🩸 MTP — ABC Score Calculator
📌
NoteThe ABC Score is intended for use in teenagers and adults only. It is not validated for use in young pediatric patients.
Select all that apply. A score ≥ 2 is likely to require MTP.
ABC Score
0
Select criteria above
🧠
Calculator
Pediatric GCS Calculator
For patients 2 years of age or younger. Tap to calculate GCS by selecting responses for Eye, Verbal, and Motor.
≤ 2 YearsInteractive
🧠
Calculator
GCS Calculator
For patients older than 2 years. Tap to calculate GCS by selecting responses for Eye, Verbal, and Motor.
> 2 YearsInteractive
Pediatric GCS Calculator
Select one response per category
Eye Opening
Verbal Response
Motor Response
Glasgow Coma Scale
For patients older than 2 years · Select one per category