SJH Emergency Medicine
If more immediate advice required, contact the Paediatric Orthopaedic Registrar on call at RHCYP (see contacts page). Only contact overnight if admission is required or if emergent management needed i.e., concern about neurovascular status. Otherwise refer to the trauma meeting.
Paediatric orthopaedic referrals
Warning
Paediatric orthopaedic referrals at SJH ED can be done in a number of ways, depending on clinical urgency. It is worth noting that the system slightly differs from adult TTC referrals. Please consider the urgency of the situation, and click the relevant drop down sections to get further information.
If you are unsure which discharge option is most appropriate please discuss with the ED senior on shift.
When reviewing formal radiology x-ray reports, if the report differs from the clinical interpretation documented please consider whether this change requires a more urgent response, even if a TTC referral has already been placed.
If you think a paediatric orthopaedic injury needs to be reviewed by the team urgently (within 7 days) please do one of the following:
- Give initial management plan to parents, document this plan clearly and discharge the patient to the RHCYP Trauma Meeting to ensure the Orthopaedic Team are happy. (See the section below about how to refer to the trauma meeting). Parents will only receive a call if the ortho plan differs from the one we have documented.
- If more immediate advice required, contact the Paediatric Orthopaedic Registrar on call at RHCYP (see contacts page). Only contact overnight if admission is required or if emergent management needed i.e., concern about neurovascular status. Otherwise refer to the trauma meeting.
Paediatric TTC referrals: this service only runs for SJH referrals (it's not used by RHCYP), therefore it does not have the staffing or resource that the adult TTC service does. The consequence is that referrals are likely to only be looked at on a weekly basis rather than daily.
One of the reasons for delay to TTC review is the volume of referrals. In order to help with this please do not refer patients anything on the "Things NOT to refer to paediatric TTC" section below.
The Paediatric Guidelines on the intranet give advice on how to manage these and there are specific leaflets available for them both on the intranet and the Right Decisions App. If you are unsure please discuss with a Consultant (or Registrar overnight) and document who you have discussed with.
Soft tissue injuries should not be referred to TTC (with the exception of suspected knee ligament injury). Please give mobilisation advice and consider physio referral card for parents to self refer if not improving.
Do not refer the following things to the SJH paediatric TTC:
- Buckle fractures
- Clavicle fractures (see PIL)
- Scaphoid (clinical) fractures
- Soft tissue injuries (except suspected knee ligament injury)
To refer a patient to the RHCYP trauma meeting write your notes as normal
- Do not use the TTC referral hyperlink
- Ensure the parents contact details are correct on Trak
- Ensure a clear provisional plan has been documented and given to the parents
- Explain to parents that they will only receive a call if this plan changes
- On the ED discharge screen, in ‘Other Discharge Conditions’, select ‘Trauma Meeting (RHCYP)’
- Example:
- Example:
- Discharge the patient off the ED screen as normal.