Wolfson Children’s Hospital Emergency Center and Porter Family Trauma Center

Jacksonville, Florida

The emergency department staff at Wolfson Children’s Hospital Emergency Center and Porter Family Trauma Center is most proud of its pediatric trauma-focused initiatives. First, the team streamlined trauma and medical resuscitation documentation. The goal was to achieve real-time documentation on Day 1 of go-live as the department transitioned to the EPIC emergency medical records system. Through robust educational efforts, the team was able to document a trauma activation with confidence. Additionally, the ED team installed large trauma screens at the head of the bed in each trauma/resuscitation bay. These screens are utilized as display boards to include real-time direct visualization of nursing computer documentation.

Second, the ED devised a plan to administer antibiotics to pediatric patients with open fractures within 60 minutes of arrival, adhering to guidelines from ACS TQIP. Open fractures in pediatric patients, while uncommon, pose significant risks for morbidity if infected and are considered orthopedic emergencies. Studies have shown that delayed antibiotic administration correlates with increased infection rates in open fracture patients. The team adopted the mnemonic RETSO, which stands for Recognition – Examine skin – Tell ED MD – Start INT – Order, for standardized practice.