CUPS Assessment for Pediatric Trauma

Category Assessment Actions Example

Critical Absent airway,breathing, orcirculation

Perform rapid initialinterventions andtransport simultaneously

Severe traumaticinjury withrespiratory arrest orcardiac arrest

Unstable Compromisedairway, breathing,or circulation withaltered mental status

Perform rapid initialinterventions andtransport simultaneously

Significant injurywith respiratorydistress, activebleeding, and shock

Potentiallyunstable

Normal airway,breathing,circulation, andmental status; high-risk mechanism ofinjury

Perform initialassessment withinterventions; transportpromptly; begin focusedhistory and detailedphysical exam duringtransport if time allows

Minor fractures;pedestrian struck bycar but with goodappearance andnormal initialassessment; historyof loss ofconsciousness

Stable Normal airway,breathing,circulation, andmental status ANDlow-risk mechanismof injury*

Perform initialassessment withinterventions; dofocused history anddetailed physicalexamination as needed;transport

Small lacerations,abrasions, orecchymoses

*Children who appear stable and have a higher-risk mechanism of injury should be consideredpotentially unstable. Based on CUPS Assessment Table 1997 N. D. Sanddal, et al. Critical Trauma Care by the Basic EMT, 4th ed.

Mechanisms and Patterns of Blunt Trauma Injury

Higher-Risk Mechanisms* Resulting Patterns of Injury

Unrestrained passenger inmotor vehicle crash

Head and neck injuriesInternal injuries to abdomen and chestExtremity injuries

Hit and thrown by motor vehicle

Head and neck injuriesInternal injuries to abdomen and chestFractures of the lower extremities

Struck by air bag Head and neck injuriesEye and facial burns

Run over by motor vehicle Internal injuries to abdomen and chestFractures of the pelvis and lower extremities

Diving into shallow water Head, neck, and cervical spine injuries

Moderate fall (515 feet)

Head and neck injuriesFractures of upper and lower extremities

High fall (15 feet or more)

Head and neck injuriesInternal injuries to abdomen and chestFractures of upper and lower extremities

Fall from bicycle (child not wearing helmet)

Head and neck injuriesLacerations to scalp and faceFractures of upper extremities

Handlebar injuries frombicycle crash

Internal injuries in the abdominal areaInternal bleeding

Lower-Risk Mechanisms Resulting Patterns of Injury

Restrained passenger in motorvehicle crash

Head and neck injuriesLacerations to scalp and faceInternal injuries to abdomen and chestInjuries of the lower spine

Low fall (5 feet or less) Fractures of upper extremities

Fall from bicycle (child wearing helmet)

Fractures of upper extremities

*A well-appearing child with a high-risk mechanism of injury shouldreceive a minimum CUPS assessment of Pnever S.