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 Rapid Infuser helpful reminders.
Protocol
🎬
Video Series
10-Minute Trauma Talks
Pediatric Trauma Video Education Series. All videos are 10 minutes or less.
Video Education⏱ ≤ 10 min each
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
🚫 Do Not Use with Central Lines
Do NOT USE with any central lines. The internal diameter cannot support the pressure generated from the Belmont and may cause damage to the line and/or injury to the patient.
⚠️ 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
Hyphema
⏱ 6 min 50 sec
Pediatric Glasgow Coma Scale
⏱ 9 min 42 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.
Resuscitation
🚨
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
🚫 Do Not Use with Central Lines
Do NOT USE with any central lines. The internal diameter cannot support the pressure generated from the Belmont and may cause damage to the line and/or injury to the patient.
⚠️ 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
Data & Statistics
Including CPG, Protocol & Policy Compliance
📊
Volume & Case Mix
CY2026
View monthly volume and case mix data for Calendar Year 2026.
2026Monthly Breakdown
📈
Annual Summary
Annual Summary
Year-to-date cumulative volume and case mix totals for CY2026.
2026YTD Totals
📋
Compliance
CPG, Protocol, & Policy Compliance
Clinical Practice Guideline, protocol, and policy compliance data.
CY2026Compliance Metrics
CPG, Protocol, & Policy Compliance
CY2026 — Compliance Metrics
📋 Compliance by Category
Annual Summary
CY2026 — Year-to-Date Totals
📈
Annual summary data coming soon. This will update as monthly data is added.
CY2026
Volume & Case Mix — Select a Month
January
2026
February
2026
March
2026
April
2026
May
2026
June
2026
July
2026
August
2026
September
2026
October
2026
November
2026
December
2026
Volume & Case Mix — 2026
📊
Data coming soon for this month.
Reference
Calculators & Quick Reference
⚖️ Pounds to Kilograms Converter
Kilograms (kg)
—
Enter weight in pounds to convert
🩹
Clinical Decision Rule
TEN-4-FACESp
Bruising Clinical Decision Rule for when bruising is concerning for abuse in children <4 years of age.
Child MaltreatmentReference
🧠
Calculator
GCS Calculators
Includes calculators for patients 2 years of age or younger and older than 2 years.
InteractiveTwo versions
🩸
Screening Tool
MTP — ABC Score
A tool to screen patients for the likelihood of requiring Massive Transfusion Protocol.
Teenagers & AdultsInteractive
GCS Calculators
Select the appropriate version
🧠
Calculator
Pediatric GCS Calculator
For patients 2 years of age or younger.
≤ 2 YearsInteractive
🧠
Calculator
GCS Calculator
For patients older than 2 years.
> 2 YearsInteractive
MTP — ABC Score
Massive Transfusion Protocol Screening Tool
📌
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
TEN-4-FACESp
Bruising Clinical Decision Rule
For when bruising is concerning for abuse in children <4 years of age.
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