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triage in pediatric trauma

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https://www.readbyqxmd.com/read/29913645/a-pediatric-patients-pain-evaluation-in-the-emergency-unit
#1
Anette Lemström
AimsHelsinki University Hospital for Children and Adolescents treats 0-to 16-year old pediatric and surgical patients. The patients arrive to the emergency unit by ambulance, referral or by decision of the triage nurse. The most common reason for visit is pain. VAS pain scale should be used, but pain is not evaluated properly. The aim of this study was to review literature on evaluation and treatment of pain in pediatric emergency unit. MethodsA search from Cinahl and Finnish Medic-database covering last 10 years was performed using: pain, child, trauma, documentation, evaluation, emergency and assessment as keywords...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29799916/accuracy-of-pediatric-trauma-field-triage-a-systematic-review
#2
Rogier van der Sluijs, Eveline A J van Rein, Joep G J Wijnand, Luke P H Leenen, Mark van Heijl
Importance: Field triage of pediatric patients with trauma is critical for transporting the right patient to the right hospital. Mortality and lifelong disabilities are potentially attributable to erroneously transporting a patient in need of specialized care to a lower-level trauma center. Objective: To quantify the accuracy of field triage and associated diagnostic protocols used to identify children in need of specialized trauma care. Evidence Review: MEDLINE, Embase, PsycINFO, and Cochrane Register of Controlled Trials were searched from database inception to November 6, 2017, for studies describing the accuracy of diagnostic tests to identify children in need of specialized trauma care in a prehospital setting...
May 16, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#3
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29735228/direct-air-versus-ground-transport-predictors-for-rural-pediatric-trauma
#4
Andrew B Starnes, Babawale Oluborode, Curtis Knoles, Boyd Burns, Henderson McGinnis, Kenneth Stewart
OBJECTIVE: Traumatic injury is the leading cause of mortality in children and the most common cause of emergency medical services transport in pediatric populations. We aimed to identify what factors are currently associated with selection for helicopter transport (HEMS) over ground ambulance (GEMS) in a primarily rural state. METHODS: We performed a retrospective case-control study of trauma patients younger than 18 years old reported to the Oklahoma State Trauma Registry between 2005 and 2014 who received direct transport from the scene of injury to a tertiary trauma center within the state...
May 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29698341/early-hospital-discharge-after-helicopter-transport-of-pediatric-trauma-patients-analysis-of-rates-of-over-and-undertriage
#5
Aodhnait S Fahy, Stephanie F Polites, Cornelius A Thiels, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, Scott P Zietlow, Donald H Jenkins, Martin D Zielinski
OBJECTIVES: Helicopter air ambulance (HAA) of pediatric trauma patients is a life-saving intervention. Triage remains a challenge for both scene transport and interhospital transfer of injured children. We aimed to understand whether overtriage or undertriage was a feature of scene or interhospital transfer and how in or out of state transfers affected these rates. METHODS: Children (<18 years) who underwent trauma activation at a level I trauma center between 2011 and 2013 were identified and reviewed...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29519567/prehospital-education-in-triage-for-pediatric-and-pregnant-patients-in-a-regional-trauma-system-without-collocated-pediatric-and-adult-trauma-centers
#6
Sarah B Cairo, Malachi Fisher, Brian Clemency, Charlotte Cipparone, Evelyn Quist, Kathryn D Bass
PURPOSE: Patient triage to the appropriate destination is critical to prehospital trauma care. Triage decisions are challenging in a region without collocated pediatric and adult trauma centers. METHODS: A regional survey was administered to emergency medical response units identifying variability and confusion regarding factors influencing patient disposition. A course was developed to guide the triage of pediatric and pregnant trauma patients. Pre- and posttests were administered to address course principles, including decision making and triage...
May 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29450701/burden-characteristics-and-process-of-care-among-the-pediatric-and-adult-trauma-patients-in-botswana-s-main-hospitals
#7
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29431096/introduction-of-pediatric-physiological-and-anatomical-triage-score-in-mass-casualty-incident
#8
Chiaki Toida, Takashi Muguruma, Takeru Abe, Mafumi Shinohara, Masayasu Gakumazawa, Naoki Yogo, Aya Shirasawa, Naoto Morimura
BACKGROUND: Triage has an important role in providing suitable care to the largest number of casualties in a disaster setting, but there are no secondary triage methods suitable for children. This study developed a new secondary triage method named the Pediatric Physiological and Anatomical Triage Score (PPATS) and compared its accuracy with current triage methods. METHODS: A retrospective chart review of pediatric patients under 16 years old transferred to an emergency center from 2014 to 2016 was performed...
April 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29429772/reliability-of-glasgow-coma-score-in-pediatric-trauma-patients
#9
Sandra R DiBrito, Marcelo Cerullo, Seth D Goldstein, Susan Ziegfeld, Dylan Stewart, Isam W Nasr
BACKGROUND: Discordant assessments of Glasgow Coma Score (GCS) following trauma can result in inappropriate triage. This study sought to determine the reliability of prehospital GCS compared to emergency department (ED) GCS. METHODS: We conducted a retrospective review of traumas from 01/2000 to 12/2015 at a Level-1 pediatric trauma center. We evaluated reliability between field and ED GCS using Pearson's correlation. We ascertained the difference between prehospital and ED GCS (delta-GCS)...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29367055/characterization-of-the-occult-nature-of-frequently-occurring-pediatric-motor-vehicle-crash-injuries
#10
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC)...
April 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29352678/e-bike-related-trauma-in-children-and-adults
#11
Itai Gross, Daniel J Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BACKGROUND: Electric bike (e-bike) usage is growing worldwide, and so is the e-bike-related injury rate. OBJECTIVE: This study was undertaken to characterize e-bike-related injuries. METHODS: Data of all e-bike-related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike-related injuries were then analyzed separately and compared. RESULTS: Forty-eight patients suffering from e-bike-related injuries presented to our trauma center between January 1, 2014 and December 31, 2016...
January 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29333809/assessment-of-orofacial-pain-management-in-a-pediatric-emergency-department-and-at-home-after-discharge
#12
Yurena Aguilar de la Red, Gema Manrique Martín, Gloria Guerrero Marquez, Concepción González Herrero, Paula Vázquez López, Concepción Míguez Navarro
INTRODUCTION: An inadequate pain management is common in the emergency department. Our objective was to analyze pain management among children with an orofacial infection or trauma in the emergency department and to assess compliance and satisfaction with analgesia prescribed at discharge. POPULATION AND METHODS: Cross-sectional, observational and analytical study in children attending the emergency department for an orofacial infection or trauma over 2 months. Pain management in the emergency department, analgesia prescribed at home and, following a call to parents, treatment provided and its adequacy to control pain were registered...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#13
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29215711/triage-tools-for-detecting-cervical-spine-injury-in-pediatric-trauma-patients
#14
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
#15
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...
December 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
#16
(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
#17
(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
#18
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...
January 2018: 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
#19
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
#20
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...
December 2017: Pediatric Critical Care Medicine
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