Key Messages

The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This paediatric trauma guideline provides advice on the initial management and transfer of major trauma patients who present to Victorian health services with severe injuries.

This guideline is developed for all clinical staff involved in the care of trauma patients in Victoria. It is intended for use by frontline clinical staff that provides early care for major trauma patients; those working directly at the Major Trauma Service (MTS) as well as those working outside of a MTS.

These guidelines provide the user with accessible resources to effectively and confidently provide early care for critically injured patients. They provide up-to-date information for front-line healthcare clinicians. The guideline is evidence based, has followed the AGREE methodology for guideline development and is auspiced by the Victorian State Trauma Committee.

Principles of early management in the paediatric
patient are the same as for adults
Image used with permission from Ambulance Victoria

Clinical emphasis points

  • Initial assessment of a seriously injured child should follow the same structured approach as that of adult assessment; life-threatening injuries should be rapidly identified and managed.
  • Delayed management of the obstructed airway and inadequate fluid resuscitation are two of the most preventable causes of death in paediatric patients.
  • Intubation should not be attempted by an inexperienced clinician.
  • Endotracheal intubation must be verified with CO2 detection.
  • The necessity of frequent reassessment cannot be overemphasised.
  • The family of the child with a significant trauma requires appropriate support and explanation.
  • The main goal of early care is to ensure optimum resuscitation in the emergency setting as well as activation of the retrieval network, with timely transfer to an appropriate facility.
  • Specific actions to implement updated guidelines in the workplace environment are essential to ensure they are utilised in the best way possible.
  • For all paediatric trauma patients, PIPER is the first point of call to initiate early retrieval and transfer (1300 137 650). PIPER will coordinate connection to the paediatric trauma line and retrieval services as required.
  • It is key to ensure the level of care is maintained from primary facility throughout the retrieval to reach the MTS.