Guidelines For Trauma Definition

Definition of major Trauma
Activate local trauma plan

1. Unresponsive to voice commands
2. Unstable blood pressure:
   1. Adult:
      1. Systolic Blood Pressure < 90 mmHg
   2. Pediatric:
      1. Infant < 2 years < 65 mmHg
      2. Child 2 – 5 years < 70 mmHg
      3. Child 6 – 12 years < 80 mmHg
3. Respiratory rate:
   1. Adult: Less than 10 or greater than 30 breaths per minute
   2. Pediatrics under 12: Less than 10 and greater than 60 breaths per minute
   3. Ineffective breathing, grunting or stridor in a child
4. Penetrating injury to head, neck, torso or proximal extremity
5. Flail chest
6. Trauma with concurrent burns greater than 15% Body Surface Area
7. Distended, rigid abdomen with signs of shock
8. Two or more proximal long bone fractures
9. Depressed or open skull fracture
10. Unstable pelvic fracture
11. New onset paralysis
12. Amputation proximal to wrist or ankle

Indicators of possible Major Trauma
Have high suspicion. Consider trauma plan activation.

1. Ejection from automobile during crash
2. Death of another occupant of same vehicle in a crash
3. Extrication time in excess of 20 minutes
4. Falls from higher than 20 feet. Use 10 feet for a child
5. Victim of a roll over motor vehicle crash
6. Victim of a high speed vehicle crash; >40mph, >20mph for a child
7. Major auto deformity, intrusion of damage into passenger compartment
8. Auto vs. pedestrian or bicycle
9. Pedestrian thrown or run over
10. Any motorcycle crash
11. Trauma patient with extremes of age <5 or >55
12. Injured patient with underlying lung or cardiac disease
13. Injured patient who is pregnant
14. Injured patient who is immunosupressed
15. Injured patient with bleeding disorder or who is on anticoagulation medication

RTAC - First published: 11/24/02 Last updated : 11/07/09 webmaster@surgery.wisc.edu
Copyright © 2004 The Board of Regents of the University of Wisconsin System