DATE: April 28, 2000
TO: DEM Staff Division of Multisystem Trauma Staff FROM:
Larry M. Jones, M.D., Director, Trauma Services and Burn Center
Bruce A. MacLeod, M.D., Chairman, Department of Emergency Medicine
RE: TRAUMA CONSULTATION GUIDELINES
The Pennsylvania Trauma System Foundation requires trauma system involvement
with patients who are admitted to the hospital with traumatic injuries. There
has been some misunderstanding about which patients should be evaluated by the
trauma service. Beginning May 1, 2000 the following guidelines should be
followed.
1) All patients admitted to the hospital with any traumatic injury, no matter
how minor (i.e., abrasion, contusion, minor closed head injury, etc.) should
have a trauma consult initiated as soon as possible during the ED evaluation.
-- Any changes in the anticipated admission service will be coordinated by the
trauma attending.
-- This applies to the pediatric patient population as well.
2) Patients with single system traumatic injuries (i.e. fractures, traumatic
intracranial hemorrhage, etc.) will be admitted to the trauma service
initially.
-- This excludes isolated hip fractures.
3) Trauma consults should be initiated by the DEM attending speaking with the
trauma attending concomitantly with paging of the trauma resident.
-----------------------------------------------
November 16, 1999  MEMOARANDUM TO: DEM STAFF
FROM: Gary Pollock, MD Trauma Coordinator, Department of Emergency Medicine
RE: SUMMARY OF NEW CHANGES IN THE DEM/TRAUMA PROCESS
1. Transfers of trauma patients from another facility which happened
acutely (not on the floor for days) will be added to the trauma alert criteria.
2. Consults regarding clear cut admits (especially of internal alerts) to 
the trauma service are expected to be placed within 30 minutes of patient
arrival to the DEM.
3. Get TACC involved when accepting a patient in transfer from another 
facility, get the name and phone number of the person wishing to send them,
so that TACC can alert the trauma attending on call of an incoming patient.
4. Fill out the pumpkin sheet as completely as possible when you accept a 
trauma patient.
5. On internal alert HELICOPTER transports, the DEM internal alert team
and trauma attending will be responding to the resuscitation.
6. ALL patients who have suffered a traumatic injury and require admission 
will be evaluated by the trauma service. If they are to be admitted to a
surgical service, they will be admitted to TRAUMA even if it is a unisystem
injury (e.g, factures, head trauma).
   This is only intended to be a summary of the new changes. As with any new
changes, there will be kinks in the system that we must all try to work out.
   I know there are going to be vague areas, but try to work through this
system as much as possible.
   Please notify me of any significant problems, issues, or concerns.
--Gary Pollock, M.D.

> From: Pollock MD, Gary
> Sent: Wednesday, May 10, 2000 5:52 PM
> To:   Packard, Linda
> Subject:
>
> Linda,
> Could you please send an email to all the DEM attendings stating that
> they should be aware that patients with a single system injury i.e.
> ankle fx that is admitted, should be admitted to trauma and thus seen
> and evaluated by trauma ASAP once the decision to admit is made.  This
> will likely decrease our LOS in the DEM for these patients and give them
> the benefits of the trauma services - i.e. drug and alcohol rehab,
> social services etc. Several cases have been referred to me recently
> since we started the new criteria May 1. Thanks Gary