Co-Management of Pediatric Trauma
Patients in the Pediatric Intensive Care Unit
·
Trauma patients
admitted to the pediatric ICU are co-managed by the pediatric surgery team and
the pediatric intensivist team.
Admission
of pediatric trauma patients to the Pediatric ICU
·
All trauma patients
seen in the emergency department that require ICU-level care are initially
evaluated by the pediatric surgery team.
·
The pediatric surgery
attending then directly discusses the patient with the pediatric
intensivist.
·
Upon evaluation, a
joint decision is made between the pediatric surgery attending and pediatric
ICU attending as to whether or not ICU-level care is indicated.
·
Upon acceptance to
the ICU, the pediatric surgeons and the pediatric intensivists devise a plan of
care together.
·
Very rarely, a trauma
may be directly admitted to the pediatric intensive care unit from a referring
facility. In that case, the transfer center will contact the pediatric
intensivist who should then involve the attending pediatric surgeon on-call for
joint pre-transfer decision making. Upon arrival
to the ICU, the pediatric surgery team should be immediately notified.
Management
of pediatric trauma patients in the Pediatric ICU
·
Daily joint rounds
are conducted with the pediatric ICU team and the pediatric surgery team
regarding these patients.
·
Orders are placed by
the pediatric intensivist team.
·
Criteria for
contacting the pediatric surgery team regarding changes in the patient
condition will be clearly delineated to the pediatric intensivists and nurses
caring for the patients.
·
Close communication
between pediatric surgical and ICU teams occurs day and night regarding
plans of care and changes in condition.