64J-2.005. Pediatric Trauma Scorecard Methodology

(1) Each EMS provider shall ensure that upon arrival at the location of an incident, the EMT or paramedic shall assess the pediatric trauma patient by evaluating the patient’s status for each of the following components: Airway, Consciousness, Circulation, Fracture, Cutaneous and the pediatric patient’s size when used in conjunction with the other components in subsection (3) of this section. The assessment of the pediatric patient using the weight and length parameter and the other components of this section shall be referred to as the Pediatric Trauma Scorecard Methodology. In assessing the pediatric patient, the criteria for each of the components in subsections (2) and (3) of this section shall be used to determine the transport destination for pediatric trauma patients.

(2) The EMT or paramedic shall assess all pediatric trauma patients using the following criteria and if any of the following conditions are identified, the patient shall be considered a pediatric trauma alert patient:

(a) Airway: In order to maintain optimal ventilation, the patient is intubated, or the patient’s breathing is maintained through such measures as manual jaw thrust, continuous suctioning or through the use of other adjuncts to assist ventilatory efforts.

(b) Consciousness: The patient exhibits an altered mental status that includes: drowsiness, lethargy, the inability to follow commands, unresponsiveness to voice, totally unresponsive, or is in a coma or there is the presence of paralysis; or the suspicion of a spinal cord injury; or loss of sensation.

(c) Circulation: The patient has a faint or nonpalpable carotid or femoral pulse or the patient has a systolic blood pressure of less than 50 mmHg.

(d) Fracture: There is evidence of an open long bone (humerus, (radius, ulna), femur, (tibia or fibula)) fracture or there are multiple fracture sites or multiple dislocations (except for isolated wrist or ankle fractures or dislocations).

(e) Cutaneous: The patient has a major soft tissue disruption, including major degloving injury, or major flap avulsions or 2nd or 3rd degree burns to 10 percent or more of the total body surface area, or amputation at or above the wrist or ankle, or any penetrating injury to the head, neck or torso (excluding superficial wounds where the depth of the wound can be determined).

(3) In addition to the criteria listed in subsection (2) of this section, a trauma alert shall be called when a condition is identified from any two of the components included in subsection (3) of this section.

(a) Consciousness: The patient exhibits symptoms of amnesia, or there is loss of consciousness.

(b) Circulation: The carotid or femoral pulse is palpable, but the radial or pedal pulses are not palpable or the systolic blood pressure is less than 90 mmHg.

(c) Fracture: The patient reveals signs or symptoms of a single closed long bone fracture. Long bone fractures do not include isolated wrist or ankle fractures.

(d) Size: Pediatric trauma patients weighing 11 kilograms or less, or the body length is equivalent to this weight on a pediatric length and weight emergency tape (the equivalent of 33 inches in measurement or less).

(4) In the event that none of the criteria in subsections (2) or (3) of this section are identified in the assessment of the pediatric patient, the EMT or paramedic can call a “Trauma Alert” if, in his or her judgment, the trauma patient’s condition warrants such action. Where EMT or paramedic judgment is used as the basis for calling a trauma alert, it shall be documented in the patient care record in accordance with Rule 64J-1.014, F.A.C.

Specific Authority 395.405, 395.4045, 401.35 FS. Law Implemented 395.401, 395.4015, 395.402, 395.4025, 395.4045, 395.405, 401.30, 401.35 FS. History–New 8-4-98, Amended 2-20-00, 9-3-00, Formerly 64E-2.0175.