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triage in pediatric trauma

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https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#1
REVIEW
Annelie Slaar, M M Fockens, Junfeng Wang, Mario Maas, David J Wilson, J Carel Goslings, Niels Wl Schep, Rick R van Rijn
BACKGROUND: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging is needed in adults presenting for blunt trauma screening at the emergency department...
December 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29198715/predicting-mortality-hospital-length-of-stay-and-need-for-surgery-in-pediatric-trauma-patients
#2
Shahrokh Yousefzadeh Chabok, Fatemeh Ranjbar Taklimie, Reza Malekpouri, Alireza Razzaghi
PURPOSE: Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score (ISS), new injury severity score (NISS) and revised trauma score (RTS) on children's mortality, hospitalization and need for surgery. METHODS: In this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included...
November 4, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29189694/committee-opinion-no-726-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#3
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29189692/committee-opinion-no-726-summary-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#4
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29174350/predicting-pediatric-patients-who-require-care-at-a-trauma-center-analysis-of-injuries-and-other-factors
#5
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, R Shayn Martin, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Triage decision correctness for children in motor vehicle crashes can be affected by occult injuries. There is a need to develop a transfer score (TS) metric for children that can help quantify the likelihood that an injury is present that would require transfer to a trauma center (TC) from a non-TC, and improve triage decision making. Ultimately, the TS metric might be useful in an advanced automatic crash notification algorithm, which uses vehicle telemetry data to predict the risk of serious injury after a motor vehicle crash using an approach that includes metrics to describe injury severity, time sensitivity, and predictability...
November 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29108845/validation-of-the-age-adjusted-shock-index-using-pediatric-trauma-quality-improvement-program-data
#6
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Shannon Acker, Denis Bensard, Brian Kenney
PURPOSE: In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. METHODS: We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28945629/critical-care-resource-utilization-and-outcomes-of-children-with-moderate-traumatic-brain-injury
#7
Theerada Chandee, Vivian H Lyons, Monica S Vavilala, Vijay Krishnamoorthy, Nophanan Chaikittisilpa, Arraya Watanitanon, Abhijit V Lele
OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: National Trauma Data Bank. PATIENTS: Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9-13) in the National Trauma Data Bank between 2007 and 2014. MEASUREMENT AND MAIN RESULTS: We examined clinical characteristics, critical care resource utilization, and discharge outcomes...
September 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28755763/reliability-of-triage-nurses-and-emergency-physicians-for-the-interpretation-of-the-c-3po-rule-for-head-trauma-in-children
#8
Jocelyn Gravel, Serge Gouin, Annie Canuel, Benoît Mâsse
INTRODUCTION: The C-3PO rule has been validated for use by emergency physicians to identify young children at risk of skull fracture following head trauma. The use of the rule by triage nurses could improve patient flow in the emergency department. OBJECTIVES: To evaluate the interobserver agreement of triage nurses and emergency physicians in the interpretation of the C-3PO rule in a pediatric emergency department. METHODS: This was a prospective observational study performed in a consecutive sample of children visiting a single emergency department...
July 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#9
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
July 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#10
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and health care costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001 to 2013 among 45 hospitals in Utah's statewide trauma system...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538607/evaluation-of-highest-level-pediatric-trauma-activation-criteria
#11
Jessica A Zagory, Minna M Wieck, Brooke E Lerner, Suzanne Moody, Richard A Falcone, Rita V Burke
BACKGROUND: Despite the presence of a tiered in-hospital trauma triage system for the past decade, trauma centers still struggle with a definitive list of highest level activation criteria. In 2002, the American College of Surgeons (ACS) mandated 6 criteria for highest level activation. However, it is unknown if pediatric trauma centers follow these criteria. The purpose of this study is to identify and categorize the highest level pediatric trauma criteria used by pediatric trauma centers in the United States...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28520684/pediatric-trauma-undertriage-in-ohio
#12
Juan P Gurria, Lynn Haas, Misty Troutt, Suzanne Moody, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio, there are 6 verified pediatric trauma centers (PTCs) across 8 state regions. The purpose of this study was to better understand the pediatric undertriage rates in the state. METHODS: We used the Ohio Trauma Registry from 2007 to 2012, consisting of 14,045 records of children younger than 16 years admitted to a hospital for more than 48 hours or who sustained a traumatic death...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#13
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
July 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28350717/missed-fractures-in-infants-presenting-to-the-emergency-department-with-fussiness
#14
Jamie S Kondis, Jared Muenzer, Janet D Luhmann
OBJECTIVES: The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. METHODS: This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328672/pediatric-trauma-under-triage-in-ohio
#15
Juan P Gurria, Lynn Haas, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Misty Troutt, Suzanne Moody, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio there are 6 verified pediatric trauma centers (PTC) across 8 state regions. The purpose of this study was to better understand the pediatric under-triage rates in the state. METHODS: We utilized the Ohio Trauma Registry from 2007 - 2012, consisting of 14,045 records of children < 16 years admitted to a hospital for greater than 48 hours or who sustained a traumatic death...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28272111/disability-risk-in-pediatric-motor-vehicle-crash-occupants
#16
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel
BACKGROUND: Mortality rates among children in motor vehicle crashes (MVCs) are typically low; however, nonfatal injuries can vary in severity by imposing differing levels of short- and long-term disability. To better discriminate the severity of nonfatal MVC injuries, a pediatric-specific disability risk (DR) metric was created. METHODS: The National Automotive Sampling System 2000 to 2011 was used to define the top 95% most common Abbreviated Injury Scale (AIS) 2+ injuries among pediatric MVC occupants...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28235428/validation-of-a-hand-held-point-of-care-device-for-lactate-in-adult-and-pediatric-patients-using-traditional-and-locally-smoothed-median-and-maximum-absolute-difference-curves
#17
Jessica Marie Colon-Franco, Stanley F Lo, Sergey S Tarima, David Gourlay, Amy L Drendel, E Brook Lerner
BACKGROUND: Lactate is commonly used in septic patients and is a viable biomarker for trauma patients. Its pre-hospital use could assist triaging and managing patients with these conditions. METHODS: We evaluated the analytical performance of the point-of-care (POC) StatStrip Xpress Lactate Meter (Nova Biomedical) and compared it to the ABL 800 (Radiometer). We measured lactate in 250 adult and 250 pediatric whole blood samples in 2 laboratories. The performance of the POC meter was assessed by traditional linear regression and Bland-Altman plots, and locally-smoothed (LS) median absolute difference and maximum absolute difference (MAD and MaxAD) curves...
February 21, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28132766/piloting-a-pediatric-trauma-course-in-western-jamaica-lessons-learned-and-future-directions
#18
Hadley K Wesson, Valerie Plant, Marieka Helou, Karen Wharton, Delroy Fray, Jeffrey Haynes, Charles Bagwell
INTRODUCTION: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development...
July 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28108126/expert-perspectives-on-time-sensitivity-and-a-related-metric-for-children-involved-in-motor-vehicle-crashes
#19
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, Joel D Stitzel
OBJECTIVE: Advanced Automatic Crash Notification (AACN) uses vehicle telemetry data to predict risk of serious injury among motor vehicle crash occupants and can thus improve the accuracy with which injured children are triaged by first responders. To better define serious injury for AACN systems (which typically use Abbreviated Injury Scale [AIS] metrics), an age-specific approach evaluating severity, time sensitivity (TS), and predictability of injury has been developed. This study outlines the development of the TS score...
January 17, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#20
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
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