TRAUMA CONSULT GUIDELINES
Consultation is not required for:
- Isolated hip fractures
- Any patient that, in the opinion of the DEM attending, does not require admission for injuries.
- All burn injuries – call only for those injures that:
- require admission
- the need for admission is not clear and the burn surgeon’s opinion is requested. (NOTE: The burn surgeons may be able to give this advice over the telephone. The burn surgeons routinely give such advice over the telephone to outlying referring physicians.)
- Patients with both medical problems and injuries that would not require admission for the injuries if they occurred alone. For example: an elderly patient suffers a fall and contusion. If the patient is being admitted for a syncope workup and would not be admitted for the contusions, there is no need to involve the Trauma Service.
- Isolated hand injuries
Routine Trauma/Burn Clinic Follow-up:
- There is no need to call the attending trauma surgeon to inform him of scheduling a routine Trauma/Burn Clinic follow-up appointment.
- Patients who are treated for minor injuries by the DEM physicians and released (such as suturing of minor lacerations, sprains or strains or minor burns) should be referred to their PCP for follow-up. Patients without a PCP may be referred to the Trauma/Burn Clinic.
Calls to the attending trauma surgeons should continue for:
- Patients with multiple injuries
- Patients with medical illnesses in addition to their injuries where the injuries would require admission if the injuries occurred alone
- Requests for formal consults if the need for admission is uncertain
- All referrals to the Burn Service by another physician or employer
There are also certain patients that the Trauma Service has a low threshold for admission and existing treatment protocols. The attending trauma surgeon should be called for these cases which include:
- Elderly patients with rib fractures
- Patients taking anticoagulants who suffer closed head injuries
- Injuries suffered during pregnancy