The Montreal Children's Hospital (MCH) of the McGill University Health Centre is a provincially designated Pediatric and Adolescent Trauma Centre, a Neurotrauma Centre of Expertise, and an important player in the provincial trauma network. The hospital is dedicated to its trauma mandate with a well-developed Emergency Trauma Response system, a commitment to making the Pediatric Intensive Care Unit (PICU) accessible, and a variety of innovative inpatient and outpatient programs. Rapid access to expert medical, surgical, nursing, rehabilitation and psychosocial trauma care, state-of-the-art equipment, and a well-developed efficient and innovative trauma care system is paramount to increasing the chances of a positive outcome.



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Overview of Montreal Children's Hospital Trauma Centre

MCH Trauma Centre, MUHC

Trauma is a leading cause of death and disability in children and teens. Trauma by its very nature is often sudden, life altering, and can be devastating. Rapid access to expert medical, surgical, nursing, rehabilitation and psychosocial trauma care, state of the art equipment, and a mature, efficient, innovative trauma care system is paramount in increasing the chances of a positive outcome for the patient and family. At the MCH the approach to trauma care is inter-professional and involves the interplay and close collaboration of 30 departments and services. Trauma impacts not only on the patient but their family, friends, and community. Our approach encourages everyone to work together to meet the multi-faceted, complex needs of the children, teens as well as their families. This practice takes place from the patient’s initial arrival in the ER through the critical care phases, early rehabilitation and recovery stages and eventual transfer to an appropriate Rehabilitation Centre, community resource or return home with comprehensive coordinated follow-up.

Every year more than 16,000 children and teens are treated in our Emergency Department for a large variety and severity of traumatic injuries. Annually 300-350 patients sustain moderate to severe injuries, requiring hospitalization and the timely interventions of our many trauma specialists. We take great pride in being a supra-regional provincially designated Tertiary Care Level Trauma Centre and a Neurotrauma Centre of Expertise, and in the 5 inter-professional clinical programs that we have developed over the past 25 years namely: Neurotrauma; Trauma; Burn Trauma; Mild Traumatic Brain Injury; and Trauma Team Leader. Through the many teams of trauma experts involved in these different programs we provide comprehensive, individualized specialized care.  All programs are closely linked to our Trauma Education and Research Program. Additionally our Injury Prevention Program acknowledged for its leadership and knowledge sharing is intricately involved in public awareness, education, and advocacy. Our Trauma Centre enjoys a collaborative professional relationship with the local and national media, and along with being closely affiliated with the Canadian Hospitals Injury Reporting and Prevention Program facilitates the diffusion and provision of timely expertise and alerts.

In addition to our acute care programs we work closely with regional centres and community physicians following thousands of ambulatory patients annually in specialized clinics. The MCH inter-professional Concussion Clinic was cited by the MSSS and INESSS as the model for care in Quebec.

Our Trauma Research Program enables us to develop, evaluate and share our knowledge in numerous initiatives including multi-centre projects, publications in peer reviewed journals, and participation in national and international conferences. Clinical and academic teaching is also an important aspect of our mandate. Many program members hold university appointments and are regularly involved in the education of trainees from a wide variety of healthcare professions, and participate in regional, national and international forums and conferences. A year-round credited Trauma Rounds Educational Series is also available to trauma network partners. Mock traumas, journal clubs, and simulated training offer many opportunities to maintain and further develop expertise. An award winning trauma and injury prevention website makes information accessible to patients and their families, the community we care for, the partnerships we develop, the regional centres in need of our experience, and our colleagues involved in clinical care and research activities elsewhere.

The MCH Trauma Centre has many collaborative partnerships, transfer agreements, and ententes with different stakeholders in the provincial and national Trauma Networks, the RUIS and supra-regional community. Included are: adult trauma centres, regional centres, SAAQ, community physicians, INESSS, other governing bodies, Health Canada, schools, sports associations, and many others. Developing partnerships with community organizations is an excellent way to share expertise. This enables others involved in first line care to be conduits of important information on trauma and injury prevention. It also allows for a better understanding of the needs of the population, and facilitates the development of collaborative ventures. Work done has benefited other MCH departments who are able to take advantage of these already established strategic alliances, for other initiatives in their specific areas.

Although our main priority as a Trauma Centre is clinical care, many of the other initiatives undertaken by MCH Trauma enhance our ability to provide: timely expertise, fulfill our global trauma mandate, position us as leaders in the field of pediatric and adolescent trauma, and make us unique.

Professionals from the following areas are involved in providing trauma care at the MCH:


Provide comprehensive, patient and family focused tertiary level interprofessional trauma care for all types and severities of trauma. Expertise spans from the acute, sub-acute and through the early rehabilitation phases. This includes excellence in trauma care; clinical and academic teaching; injury prevention and public awareness; education; research; community outreach; networking; and advocating for the needs of Quebec children and adolescents at a local, regional, provincial and Canada wide level.


  • To provide excellent trauma care
  • To maintain a high level of expertise
  • To ensure rapid accessibility for all patients to the MCH Trauma services
  • To assist patients and their families in understanding the impact of the injury and the expected course
  • To assist children and teens in achieving their maximum functional potential during the early stages of recovery
  • To provide coordinated patient-focused care in conjunction with other institutions in the healthcare consortium in order to assure timely continuum of care
  • To provide academic teaching and clinical training
  • To be leaders in pediatric and adolescent trauma research
  • To monitor trends and play a leadership role in the development of strategies for targeted injury prevention, public awareness, advocacy and lobbying
  • To be available as an expert community resource and develop strategic alliances with others sharing a common goal in advocating for the needs of the children and teens of Quebec


Our history

 History: Montreal Children’s Hospital Trauma Centre




  • Developed 1st inter-professional Pediatric Neurotrauma Program in Quebec and Canada. Included all types and severity of Neurotrauma. Model for future Trauma Programs.



  •   1st Provincial designation as a Pediatric and Adolescent Trauma Centre (1997, 2001, 2008, 2012).



  •    Developed comprehensive approach to concussion management.



  • Re-organized and expanded Trauma mandate to include all types and severities of trauma under one inter-professional program. This brought together the medical, surgical, nursing, rehabilitation, and psychosocial aspects of trauma care.
  • Developed hospital-wide clinical protocols for management of assorted trauma.
  • Developed assorted educational materials for diffusion with community partners.    



  • MSSS designation Neurotrauma Centre of Expertise.
  • Development of numerous protocols to standardize trauma care.        
  • Teaching of Medical and Allied Health trainees on assorted Trauma topics.
  • Trauma Rounds Educational Series (Inter-professional)



  • Expanded developed Burn Trauma Program (introduced new Rx, ambulatory shift).                         
  • 1st Trauma Centre in Canada to report rise in concussions in minor Hockey.
  • Diffusion of timely trauma and injury prevention information to media.
  • Implementation of early hip spica for femur#; ambulatory shift.



  • Expanded Injury Prevention Mandate – Program status.
  • Re-organized & developed Multi-level Emergency Trauma Response System.
  • Implementation of Inter-professional Trauma Activation Quality Review Process.
  • Development of ECMO Program



  • Certified as a WHO health promoting hospital.
  • Developed MTBI and Return to Sports Program; ambulatory shift.
  • Launched the 1st edition Concussion KiT, educational resources online.                                
  • Expanded Trauma Research mandate, created official Program.



  • Expanded Concussion Clinic; community out-reach education programs with schools, municipalities, community organizations & sporting associations.
  • Purchase of transportable mini fluoroscopy machine facilitating close reductions in ER & Clinic



  • Developed many community outreach projects & partnerships.
  • Developed and launched bilingual MCH Trauma Website (recipient of multiple awards).



  •    Implementation of FAST in the Emergency Department.



  • Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) integrated into MCH Trauma System close collaboration with Injury Prevention Program.
  • Further expansion of Trauma Research Program.



  • Expansion of inter-professional MTBI Program/Concussion clinic. Concussion education
  • Increased collaboration with community physicians, teaching, and consultations.
  • Use of the Bier Block for management of upper extremity fractures in Emergency Department. 


  • Further expansion of MTBI Program to include vestibular rehabilitation.



  • Cited by MSSS/INESSS TCC léger management guidelines.
  • Implementation of attending staff Trauma Team Leader (TTL) Program. 


  • New Site of Trauma Centre
  • Opening of New Concussion Clinic at the Glen Site.
  • Development of new Headache Management Protocol for community MDs & Emergentologists.                  
  • Development of “Is the Thrill Worth It?” High School Program. 


  • On going development and expansion of Trauma Research Program.


  • Publication of 3rd edition MCH Concussion KiT 
  • Hosted Trauma Resuscitation in Kids (TRIK) course for  eastern Canada
Our team

Debbie Friedman, BSc pht, M.Mgmt

  • Director, Trauma Programs
  • Director, Canadian Hospitals Injury Prevention and Reporting Program (CHIRPP)
  • Director Trauma Research

Diane Richard, BScN Trauma Coordinator

  • Neurotrauma Program
  • Trauma Program
  • Burn Trauma Program

Debbie Schichtman, BScN Trauma Coordinator

  • Mild Traumatic Brain Injury Program
  • Concussion Clinic

Liane Fransblow, BSc. pht, MPH Trauma Coordinator

  • Injury Prevention Program

Lisa Grilli, BSc. pht, MSc Trauma Coordinator

  • Mild Traumatic Brain Injury Program
  • Concussion Clinic
  • Research Program

Carlo Galli, Physiotherapist

  • Concussion Clinic

Christine Beaulieu, Physiotherapist

  • Concussion Clinic

Meghan Straub, Physiotherapist

  • Concussion Clinic

Dr. Isabelle Gagnon, PT PhD Clinician Scientist

  • Research Program

Glenn Keays, MSc CHIRPP Coordinator

  • Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP)


Amanda Fitzgerald, B.A - APS

Michael Chuipka, B.A - Administrative Technician 

Fatemeh Bahrpeyma - B.Lit - Medical Secretary


Our programs

Trauma program:

Specializes in emergency, acute care, early rehabilitation and outpatient follow-up for all types of trauma including: musculoskeletal; spinal; thoracic; abdominal; pelvic; ocular; dental; poisoning; and near drowning.

Neurotrauma Program:

Specializes in emergency, acute care, early rehabilitation, and outpatient management for all types and severities of brain, neck and spinal cord injuries.

Concussion Clinic/Mild Traumatic Brain Injury (MTBI) Program:

Specializes in the management of mild traumatic brain injuries (also known as concussions), including: assessment, intervention plan, recommendations for return to school, and individualized plan for return to sports and recreational activities.

Burn Trauma Program:

Specializes in emergency, critical care, early rehabilitation and ambulatory management for all types and severities of burns.

Injury Prevention Program:

Involves injury prevention recommendations, education, public awareness, community outreach, partnership development, networking, and research. The MCH Trauma approach to injury prevention balances activity and fun with promoting awareness of the risks involved and making informed choices.

Trauma Research Program:

Research is a key component of trauma activities. It is important in verifying the effectiveness of our interventions and evaluating our projects and programs. Trauma team members are involved in a variety of clinical research projects and many have been published in peer-reviewed journals such as The Journal of Trauma, Brain Injury and the Journal of Head Injury Rehabilitation.

Trauma Team Leader (TTL) Program:

This program ensures urgent accessibility of the trauma team leader in charge of severe, complex and critical trauma cases in a fast and efficient manner. The trauma team leader leads the inter-professional group and ensures the delivery of excellent care from the time the patient arrives at the trauma centre through the different areas of care until the patient's final disposition to the OR, PICU, or Trauma Unit. The TTL Program is well integrated in the already established Trauma Code System.

Affiliated Programs


The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is a Canada-wide program of the Injury and Child Maltreatment Section of the Health Surveillance and Epidemiology Division, Centre for Health Promotion, Public Health Agency of the Federal Government.

Each centre involved in CHIRPP has a designated Director and Coordinator. In 2011, CHIRPP was integrated into the MCH Trauma System. In order to meet the government mandate it has been closely linked to the MCH Injury Prevention Program for research activities, development of educational materials and injury prevention awareness.

Trauma Inter-professional Education

MCH Trauma offers year-round Interprofessional CME-approved Trauma Rounds, which take place on a monthly basis. Topics include a wide variety of trauma-related subjects. Staff from many departments and services, community physicians, residents, students and trauma network partners attend rounds. The MCH Telehealth Program makes the rounds available to regional centres.


Clinical Research

Research is a core component of trauma activities. Research is important in recognizing the needs of children and adolescents, verifying the effectiveness of our interventions and evaluating our projects and programs. Members are involved in a variety of clinical research projects and have had many publications in peer-reviewed journals, such as The Journal of Trauma, Brain Injury and the Journal of Head Injury Rehabilitation. In this section, you will find results from completed projects of the Montreal Children's Hospital Trauma Programs, as well as information and updates on our current studies. It also highlights our research initiatives and collaborative work.

Chapters in books

Gagnon, I. Mild Traumatic Brain Injury in Children and Adolescents From Basic Science to Clinical Management. Pediatric Neuropsychology, Second Edition Research, Theory, and Practice. Guilford Publications, Inc. New York, NY, 2012.

Friedman D, Atkinson J, Saltaris C, Daignault S, Gagnon I. L'approche utilisée dans le programme de traumatologie de l'Hôpital de Montréal pour enfants dans le traitement du traumatisme craniocérébral léger, dansÉpidémie Silencieuse : le traumatisme craniocérébral léger symptômes et traitement. Presses de l'Université du Québec, Québec. 2008

Gagnon I, Swaine B, Friedman D, Forget R. L'identification de séquelles suite à un traumatisme crânio-cérébral léger chez l'enfant. Publications du CRIR. 2005; 2: 119-134.


Friedman D, Schopflocher C. Understanding Pediatric and Adolescent Neurotrauma. Montreal Children's Hospital, 1999.

Peer-reviewed scientific journals

Roger Zemek, MD1Nick Barrowman, PhD2Stephen B. Freedman, MDCM, MSc3Jocelyn Gravel, MD4Isabelle Gagnon, PhD5Candice McGahern, BA2Mary Aglipay, MSc2Gurinder Sangha, MD6Kathy Boutis, MD7Darcy Beer, MD8William Craig, MDCM9Emma Burns, MD10Ken J. Farion, MD1Angelo Mikrogianakis, MD11Karen Barlow, MD12Alexander S. Dubrovsky, MDCM, MSc5Willem Meeuwisse, MD, PhD13Gerard Gioia, PhD14William P. Meehan III, MD15Miriam H. Beauchamp, PhD16Yael Kamil, BSc2Anne M. Grool, MD, PhD, MSc2Blaine Hoshizaki, PhD17Peter Anderson, PhD18Brian L. Brooks, PhD19Keith Owen Yeates, PhD20Michael Vassilyadi, MDCM, MSc21Terry Klassen, MD8Michelle Keightley, PhD22Lawrence Richer, MD23Carol DeMatteo, MSc24Martin H. Osmond, MDCM1; for the Pediatric Emergency Research Canada (PERC) Concussion Team.                                             Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED.                                   JAMA. 2016;315(10):1014-1025. doi:10.1001/jama.2016.1203

Alexander Sasha Dubrovsky, Elise Mok,Suk Yee Lau, Mohammad Al Humaidan. Point tenderness at 1 of 5 locations and limited elbow extension identify significant injury in children with acutre elbow trauma: a study of diagnostic accuracy. Am J Emerg Med, 2014: Nov 29

Rajeet Singh Saluja, Jen-Kai Chen, Isabelle Gagnon, Michelle Keightley, Alain Ptito. Navigational memory fMRI: A test for concussion in children. J Neurotrauma, 2014: Oct 1.

Elana Pinchefsky, Alexander Sasha Dubrovsky, Debbie Friedman, Michael Shevell. Part II- Management of Pediatric Posttraumatic Headaches. Pediatr Neurolo, 2014: Oct 16

Alexander Sasha Dubrovsky, Anna Kempinska, Ilana Bank, Elise Mok. Accuracy of Ultrasonography for Determining Successful Realignment of Pediataric Forearm Fractures. Ann Emerg Med, 2014: Oct 16

Glenn Keays, Alex Dumas. Longboard and skateboard injuries. Injury, 2014: Aug 3:45(8):1215-9

Glenn Keays, Isabelle Gagnon, Debbie Friedman. Ringette-related injuries in young female players. Clin J Sport Med, 2014: Jul;24(4)326-30

Alexander Sasha Dubrovsky, Debbie Friedman, Helen Kocilowicz. Pediatric post-traumatic headaches and peripheral nerve blocks of the scalp: a case series and patient satisfaction survey. Headache, 2014: May 2:54(5):878-87

Michelle L Keightley, Rajeet Singh Saluja, Jen-Kai Chen, Isabelle Gagnon, Gabriel Leonard, Michael Petrides, Alain Ptito. A functional magnetic resonance imaging study of working memory in youth after sports-related concussions: is it still working? J Neurotrauma, 2014: Mar11:31(5):437-51

Glenn Keays, Robin Skinner. Playground equipment injuries at home versus those in public settings: differences in severity. Injury Prevention, 2012; Apr16:18(2):138-41

Pomerleau G, Hurteau A-M, Parent L, Doucet K, Corbin-Berrigan L-A, Gagnon I. Developmental trajectories of infants and toddlers with good initial presentation following moderate or severe traumatic brain injury: a pilot clinical assessment project. Journal of Pediatric Rehabilitation Medicine, 2012; Jan.1; 5(2):89-97

Keays G, Pless I.B. Impact of a Celebrity Death on Children's Injury-related Emergency Room Visits. Canadian Journal of Public Health, 2010; 101 (2): 115-18.

Osmond, M. H., Klassen, T.P., Wells, G. A., Correll, R. , Jarvis, A., Joubert, G., Bailey, B., Chauvin-Kimoff, L., Pusic, M., McConnell, D., Nijssen-Jordan, C., Silver, N., Taylor, B., Stiell, I.G., for the Pediatric Emergency Research Canada (PERC) Head Injury Study Group. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. Canadian Medical Association Journal, 2010; 182 (4): 341-348.

Gagnon I, Galli C, Friedman D, Grilli L, Iverson G.L. Active rehabilitation for children who are slow to recover following sport-related concussion, Brain Injury, 2009; 23: 12, 956-964.

Gagnon I, Swaine B, Forget R. Do they actually listen? Using activity diaries to measure children and adolescents' compliance with activity restrictions after a mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 2009; 22: 355-362.

Brosseau-Lachaine O, Gagnon I, Froget R, Faubert J. Complex visual information processing in children after Mild Traumatic Brain Injury. Brain Injury, 2008, 22: 657-668.

Gagnon I, Swaine B, Champagne F, Lefebvre H. Perspectives of adolescents and their parents regarding service needs following a mild traumatic brain injury. Brain Injury 2008; 22: 161-173.

Swaine B, Gagnon I, Champagne F, Lefebvre H, Friedman D, Atkinson J, Feldman D. Identifying the specific needs of adolescents after a mild traumatic brain injury: a service provider perspective. Brain Injury 2008; 22: 581-588.

Borsuk DE, Gallant M, Richard D, Williams HB. Silver-coated nylon dressings for pediatric burn victims. Can J Plast Surg; 2007; 15 (1): 29-31.

Pless, I.B., Hagel, B., Patel, H., Leduc, D., & Magdalinos, H. Preventing product-related injuries: a randomized controlled trial of poster alerts. Canadian Journal of Public Health. Revue Canadienne de Santé Publique. 98(4):271-5, 2007 Jul-Aug.

Su W, Hui T, Shaw K. All-terrain vehicle injury patterns: are current regulations effective? Journal of Pediatric Surgery, 2006; 41 (5) 931-934.

Gagnon I, Swaine B, Friedman D, Forget R. Comparing the Sensory Organization Test and the Pediatric Clinical Test of Sensory Interaction for Balance in children. Physical and Occupational Therapy in Pediatric 2006; 26: 23-41.

Pless, I.B., Magdalinos, H., & Hagel, B. Risk-compensation behavior in children: myth or reality? Archives of Pediatrics & Adolescent Medicine. 160(6):610-4, 2006 Jun.

Gagnon I, Swaine B, Friedman D, Forget R. Exploring children's self-efficacy related to physical activity performance after a Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 2005; 20: 436-449.

Gagnon I, Swaine B, Friedman D, Forget R. Children demonstrate decreased dynamic balance following a mild traumatic brain injury. Archives of Physical Medicine and Rehabilitation 2004; 85: 444-452.

Gagnon I, Swaine B, Friedman D, Forget R. Visuomotor response time in children with a mild traumatic brain injury.Journal of Head Trauma Rehabilitation 2004; 19: 391-404.

Bienkowski P, Harvey EJ, Reindl R, Berry GK, Benaroch TE, Ouellet JA. The locked flexible intramedullary humerus nail in pediatric femur and tibia shaft fractures: a feasibility study. J Pediatr Orthop 2004; 24 (6): 634-637.

Pickle A, Benaroch TE, Guy P Harvey EJ. Clinical outcome of pediatric calcaneal fractures treated with open reduction and internal fixation. J Pediatr Orthop 2004; 24 (2): 178-180.

Swaine B.R., Friedman D, Activity Restrictions as part of Discharge management for Children with a Traumatic Head Injury. Journal of Head Trauma Rehabilitation; 2001; 16 (3): 292-301.

Gagnon I, Friedman D, Swaine B, Forget R. Balance findings in a child before and after a mild head injury. Journal of Head Trauma Rehabilitation; 2001; 16(6): 595-602.

Swaine BR, Pless IB, Friedman D, Montes J. Using the Measure of Processes of Care with parents of children hospitalized for head injury. American Journal of Physical Medicine & Rehabilitation, 1999; 78 (4): 323-329.

Gagnon I, Forget R, Sullivan SJ, Friedman D. Motor performance following a mild traumatic brain injury in children: an exploratory study. Brain Injury; 1998; 12 (10): 843-853.

Swaine BR, Pless IB, Friedman D, Montes J. Parental perceptions of care provided to children hospitalized for head injury. Canadian Journal of Rehabilitation, 1998:11(4)

Research reports

Swaine B, Champagne F, Lefebvre H, Atkinson J, Feldman D, Gagnon I, Friedman D. Identification des besoins spécifiques des adolescents ayant subi un traumatisme craniocérébral léger. Rapport de recherche déposé en juillet 2006 au Programme de Recherche en Réadaptation et Intégration Sociale en Traumatologie. 101 pages.

Non peer-reviewed publications

Friedman, D. Health Promotion through Injury Prevention: The Perspective of a Paediatric and Adolescent Trauma Centre. Orthopaedic Division Review. 2011

Gagnon I, Swaine B, Friedman D, Forget R. Capacités motrices et retour aux activités physiques après un traumatisme crânio-cérébral léger chez l'enfant. Physio-Québec 28: 14-15, 2003.

Gagnon I, Forget R, Sullivan SJ, Friedman D: La performance motrice des enfants ayant subi un traumatisme crânio-encéphalique léger: une étude exploratoire. Physio-Québec 23: 18-19, 1998.

Published abstracts

Grilli L, Gagnon I, Friedman D. Duration of symptom-free period and impact on clinical outcome in children after concussion. Physiotherapy. 2011. 97: suppl 1 eS385

Gagnon I, Friedman D. Management of mild traumatic brain injury or concussion in children: is there a role for the Physical Therapist? Physiotherapy 2011. 97: suppl 1 eS1487

Isabelle Gagnon, Robert Forget, Lisa Grilli Exploring Post-concussion Symptoms in Children After an Injury: Can musculoskeletal injury bring them on? Ninth World Congress on Brain Injury; Edinburgh, Scotland; March 21-25, 2012

Grilli L, Fransblow L, Friedman D, Auclair N, Levis NP, Belluci L, Jubinville H, Galli C, Gagnon I. Collaboration amongst trauma and injury prevention experts: Addressing risky teen road behaviours. CPHA Conference: “Public Health in Canada: Innovative Partnerships for Action”; Montreal; June 19, 2011

Fransblow L, Grilli L, Friedman D, Dion D, Lauzon F, Robert JL, Ibrahim M, Gagnon I; Car seat verification clinic at a suburban community open house. CPHA Conference: “Public Health in Canada: Innovative Partnerships for Action”; Montreal; June 19, 2011

Livernoche F, Pépin K, Berry M, Friedman D, Morel J. Traumatismes par véhicule motorisé chez les enfants du Nunavik: CPHA Conference: “Public Health in Canada: Innovative Partnerships for Action”. Montreal, June 19, 2011

Friedman D, Gagnon I, Le TCC léger pédiatrique et adolescent en contexte sportif. 17e colloque Défis traumatologie ; Québec, February 24-25, 2011

Gagnon I, Galli L, Grilli L, Simard J. Assessing balance in children after a mild traumatic brain injury: Choosing the right tools. Eighth World Congress on Brain Injury, Washington March 10-14, 2010. Brain Injury. 24: 147, 2010.

Friedman D, Gagnon I, Kocilowicz H, Galli C, Grilli, L. Concussion care model Eighth World Congress on Brain Injury, Washington March 10-14, 2010. Brain Injury. 24: 333, 2010.

Hurteau A-M, Doucet K, Parent L, Gagnon I. Developmental outcome of infants with moderate and severe head injury. Eighth World Congress on Brain Injury, Washington March 10-14, 2010. Brain Injury. 24: 179, 2010.

Gagnon I, Grilli L, Galli C, Friedman D. Managing acute ankle sprains in a pediatrics emergency department: Implementing an interdisciplinary approach. Canadian Association of Sport Medicine Annual Meeting, Vancouver May 2009. Clinical Journal of Sports Medicine. 19: 249. 2009

Gagnon I, Galli C, Friedman D, Iverson G. Active rehabilitation for children and adolescents with atypical recovery following a concussion. 3rd International Conference on Concussion in Sports, Zurich, October 2008. British Journal of Sport Medicine. 43 (suppl. 1) i97, 2009

Gagnon I, Galli C, Friedman D, Simard J, Kocilowicz H, Grilli L. Returning to sports after a concussion - The Montreal Children's Hospital Return to Sports Program. 3rd International Conference on Concussion in Sports, Zurich, October 2008. British Journal of Sport Medicine. 43 (suppl. 1) i97, 2009

Gagnon I, Swaine B. Exploring the impact of Knowledge-Transfer and Exchange tools with clinicians working with teenagers who sustain mild traumatic brain injuries. ACRM-ASNR Annual Educational Conference, Toronto October 2008, Archives of Physical Medicine and Rehabilitation, 2008, 89: e31.

Gagnon I, Champagne F, Friedman D, Swaine B. Evaluating the implementation and impact of an innovative, integrated approach to identify and orient children and adolescent with MTBI in a pediatric trauma center emergency room. Seventh World Congress on Brain Injury, Lisbonne, April 8-12 2008. Brain Injury. 22: supplement 1, 190.

Gagnon I, Galli C, Friedman D. Taking care of the "miserable minority": Rehabilitation strategies for children and adolescents presenting with atypical recovery following a mild traumatic brain injury. Seventh World Congress on Brain Injury, Lisbonne, April 8-12 2008. Brain Injury. 22: supplement 1, 194.

Gagnon I, Swaine B, Champagne F, Lefebvre H, Atkinson J, Feldman D. Identifying the specific needs of adolescents after a mild traumatic brain injury: a service provider perspective. American Congress of Rehabilitation Medicine Annual Conference, Washington, October 2-7, 2007 Volume 88 , Issue 10 , Pages e18 - e19

Brosseau-Lachaine O, Gagnon I, Froget R, Faubert J. Complex visual information processing in children after Mild Traumatic Brain Injury. Vision Sciences Society Annual Meeting, 5-10 mai 2006. Journal of Vision. 2006

Gagnon I, Swaine B, Friedman D, Forget R. Diaries as an indirect measure of compliance with return to activity; guidelines given to children who sustain a mild head injury. ACRM-ASNR Annual Educational Conference, Chicago, 28 septembre-2 octobre 2005. Archives of Physical Medicine and Rehabilitation. 2005; 86: e19.

Gagnon I, Forget R, Swaine B, Friedman D. Balance findings after a mild head injury in children. 3rd World congress of Neurorehabilitation, Venise, Italie, 2-6 avril 2002, Neurorehabilitation and Neural Repair. 2002; 16: 22-3.

Gagnon I, Forget R, Swaine B, Friedman D. Transient increase in response time after a mild head injury in children, 79th Annual Meeting of the American Congress of Rehabilitation Medicine, Philadelphia, 2-6 octobre 2002.Archives of Physical Medicine and Rehabilitation. 2002; 83: 1481.

Swaine B, Gagnon I, Forget R, Friedman D. Mild traumatic brain injury affects children's confidence in their physical activity performance, 7th annual conference of the Euroacademia Multidisciplinaria Neurotrumatologica, Newcastle-upon-Tyne, UK, June 26-29 2002, Acta Neurochirurgica, 2002; 144(7): A35.

Gagnon I, Forget R, Sullivan SJ, Friedman D. Motor performance following a mild traumatic brain injury in children: an exploratory study. Annual Meeting of the American Physical Therapy Association, Orlando, Floride 4-8 juin 1998,Physical Therapy. 78: s81, 1998.


Inter-Professional Education

2015-2016 Trauma Rounds Presentations Schedule

Pediatric Faical Gunshot injuries


2014-2015 Trauma Rounds Presentations Schedule

2014-2015 presentations

Dental Trauma Rounds

The MCH Trauma Code Response System: Integrating the Trauma Team Leader Program

Pediatric burns, Inhalation injury and Burn toxicology

2013-2014 Trauma Rounds Presentations Schedule

2013-2014 presentations

What’s new in clinical toxicology?


2012-2013 presentations

Drowning update

Pediatric Concussions: latest approach to management

Pancreas Trauma Rounds

Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) at the Montreal Children’s Hospital Trauma Centre

MCH Trauma Injury Prevention Program

Abusive Head Trauma

2011-2012 presentations

Emergency Sports Equipment Removal Workshop

Trauma CT: What's the risk?

Bier Block for Fracture Reduction in the Pediatric Emergency Department

Inhalation Injury

2010-2011 presentations

Blunt Torso Trauma: A Pediatric Perspective

The Role of Laparoscopy in the Diagnosis and Management of Pediatric Trauma

Changing Trends in Pediatric Femoral Fracture

Pediatric Dental Trauma: The Old and the New

Global Disparities in Trauma Care: How you Can Help

Treating Traumatized Children: When and How

2009-2010 presentations

City mouse, country mouse: The trauma experience in a rural African environment

Wii-Hab: Using commercial videogames in rehabilitation after a pediatric trauma

Pain management in polytrauma

ER pitfalls in orthopedic trauma

Crush Syndrome

Les jouets bruyants pour bambins: Une cacophonie à risque?

Use of Oral Contrast in CT Evaluation of Pediatric Blunt Abdominal Trauma

Acute Management of Burns in Children

MCH Trauma protocols
How to refer a patient to the concussion clinic

Criteria for EARLY referral to Concussion Clinic (5-17 years of age):

We encourage early referral to our Concussion Clinic to favor optimal recovery time and minimize long term complications. Patients should be referred immediately and certainly if there is no significant improvement within 1 week following the concussion

Please send consultation if any of the following apply to the patient:

High level activities

  • Competitive sport or partakes in several team sports at the same time
  • High performance music or drama

Past medical history 

  • Previous concussion especially if symptoms lasted > few days
  • Migraines

Current event

  • Immediate onset of dizziness for current trauma
  • Immediate onset of sensitivity to motion

Current symptoms

  • Responding to questions more slowly at the time of the exam or even if briefly right after the event
  • Showing poor concentration
  • Abnormal tandem stance
  • GCS <15

Anxiety about the concussion - patient and/or family

MD discretion – Early referral recommended


Referral process: If patients present with any of the above findings, please send a medical referral to the attention of the Concussion Clinic Fax: 514- 412-4254 or call 514-412-4400 x 23310 (8am -5pm)

How to transfer a patient

The target clientele

Trauma categories determining if a child/adolescent (0 to 18 years of age) needs to be transferred to a tertiary pediatric trauma centre:

  • Child/adolescent who is intubated
  • Child/adolescent with a head injury: signs of lateralization, Glasgow Coma scale < 14
  • Child/adolescent with a mild head injury requiring observation
  • Child/adolescent with a spinal cord injury
  • Child/adolescent with a depressed or open skull fracture
  • Child/adolescent with a burn (more than 15% TBSA, 2nd degree)
  • Baby with a burn over 10% TBSA (nutritional needs)
  • Child/adolescent with a burn on the face, hands or feet
  • Child/adolescent with a burn on the perineum
  • Child/adolescent with a major trauma who is hemodynamically stable
  • Baby/infant (< 4 years old)
  • Child/adolescent requiring complex and extensive reconstruction
  • Child/adolescent with a Salter fracture or another serious type of fracture
  • Child/adolescent with a major trauma requiring cardiovascular, renal or nutritional support
  • Child/adolescent whose trauma is evaluated as non-accidental

Stabilization criteria before the transfer

Even in the case of an urgent transfer, the referring hospital must ensure that the child/adolescent is hemodynamically stable before transferring.

The following are signs of instability of vital signs in patients under 18 yeas of age:

  • Respiratory rate under 10 or over 60 per minute;
  • Systolic arterial tension under 70, over twice the patient's age in years;
  • Heart rhythm:
    If < 2 years, < 100 and > 160/min.
    If between 2 and 10 years, < 80 and > 150/min. 
    If > 10 years, < 60 and > 140/min.

In the presence of an urgent medico-surgical condition where the trauma threatens the child/adolescent's organs or life, the transfer is to be done after stabilization.

The stabilization includes an adequate evaluation and the beginning of the treatment so that, with reasonable probability, the transfer does not result in death or serious damage to the vital functioning of one of the organs.

The stabilization of the patient must include, when required:

  • Maintaining the permeability of the airways.
  • Control of any haemorrhaging.
  • Adequate immobilization of the patient or of a limb.
  • Setting up intravenous access for the administration of a solution or blood product.
  • Administering the necessary medication.
  • Necessary measures to ensure optimal stability during transfer.
  • Adequate accompaniment of the child by professionals deemed necessary to safeguard the life or corporal integrity of the patient during the transfer between the two hospital centres.

Modalities concerning the process for transferring to the MCH

Axis of communication to ensure transfer:

The emergentologist at the referring hospital must communicate the transfer request to the Emergency Department through the direct line for transfers        514-412-4499 (Emergency Department). An automated system will be activated, press 1 for transfers.

Pertinent documents to submit with the transfer:

Initial pre-transfer documents MUST be faxed to 514-412-4217 (Emergency Department Green Zone).

Ideally, this information should be transmitted prior to the patient’s arrival at the Montreal Children’s Hospital, using the polytrauma form and/or medical notes and nursing notes from the ER.

Documents to accompany the transfer:

1. Pre-hospital history (ambulance, police), forms: AS 803, AS 810, others as necessary.

2. The standard trauma form or a legible copy of the physical exam, evolutions notes and any treatments done.

3. All tests and imaging: hematology, biochemistry, blood gas, medical imaging, ECG, etc.

4. The name of the referring hospital as well as the name and contact information of the emergentologist must clearly be indicated on the first page of the transfer documents.

If the referring centre encounters a problem and needs to quickly contact the responsible parties:

  • Dr Laurie Plotnick, Medical Director, Emergency Department
    (514) 412-4400 ext. 22772 
  • Sylvie Levesque, Nurse Manager, Emergency Department, 
    (514) 412-4400 ext. 22270
  • Debbie Friedman, Director, Trauma (514) 412-4400 ext. 23310 between 8am and 5pm
Trauma Stories

Lucas Romano

Lucas Romano was a midget level hockey player. He suffered a concussion and lost consciousness during a hockey tournament after an opposing player hit him in the head. Lucas was followed by the Montreal Children’s Hospital Concussion Clinic. Here is his story.

Laura Rea


(video available in French only)

Jean-Philippe Lambert

(video available in French ony)

Injury Prevention
Treating Trauma
Important resources to manage trauma
Brochures / Pamphlets
Refer a patient 

Phone : 514-412-4400 ext. 23310

Fax : 514-412-4254

514-412-4499, Emergency Department (for patient transfer) / 514-412-4399 (fax)

Safety and wellness

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