Helicopter transport in pediatric trauma: A new methodology using Need for Surgeon Presence to evaluate the necessity of air transport

McGaha, Paul; Stewart, Katharine E.; Garwe, Tabitha; Johnson, Jeremy J.; Sarwar, Zoona; Letton, Robert W.

doi:10.1016/j.amjsurg.2019.11.034

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Air transfer, when compared with ground transfer, does not uniformly improve patient outcomes, which corroborates the previous investigations that have found that 85% of pediatric air transfers could be considered overtriage 24–26 . Furthermore, criteria for air transfer are not consistent and may be affected by geographic location, local medical resources, weather, and the capability and comfort level of the transferring parties 27 . When only 6% to 8.8% of all pediatric pelvic fractures undergo operative orthopaedic management, the benefit of these costly transfers could be questioned 9,19 …”

Section: Discussionsupporting

confidence: 84%

“…[24][25][26] Furthermore, criteria for air transfer are not consistent and may be affected by geographic location, local medical resources, weather, and the capability and comfort level of the transferring parties. 27 When only 6% to 8.8% of all pediatric pelvic fractures undergo operative orthopaedic management, the benefit of these costly transfers could be questioned. 9,19 Among our cohort, air transport was significantly associated with surgical treatment, need for PICU stay, the presence of an additional injury, and increasing severity based on the Torode/Zieg classification.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management

Igboechi

Purtell

Carry

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Existing classification systems may not adequately describe the injury patterns seen pelvic ring and acetabular fractures in the skeletally immature population. Pediatric patients, once stabilized, are often transferred for these injuries. We evaluated which commonly used systems correlate with clinical management in pediatric patients, including transfer patterns based on injury severity. Methods: A retrospective review of patients aged 1 to 15 treated for traumatic pelvic or acetabular fractures over a 10-year period at an academic level I Pediatric Trauma Center reviewed demographic, radiographic, and clinical data. Results: A total of 188 pediatric patients (average age 10.1 y) were included. Increasing injury severity based on classification Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA P<0.001; Young and Burgess P<0.001; Torode/Zieg P<0.001), increasing Injury Severity Score (P=0.0017), and decreasing hemoglobin levels (P=0.0144) were significantly associated with operative management. Injury characteristics did not differ between patients who were transferred versus patients who were brought in directly from the field. Air transport was significantly associated with surgical treatment, pediatric intensive care unit admission, polytrauma, and Torode/Zieg classification (P=0.036, <0.0001, 0.0297, 0.0003, respectively). Conclusions: Although not fully descriptive of skeletally immature fracture patterns, the AO/OTA and Young and Burgess classification systems adequately assess the severity of pelvic rings and injuries in pediatric patients and predict management patterns. The Torode and Zieg classification also predicts management. In a large cohort, air transport was significantly associated with surgical treatment, need for pediatric intensive care unit stay, the presence of an additional injury, and instability in the Torode and Zieg classification. These findings suggest that air transfers are being utilized to expedite advanced-level care in more severe injuries. Further studies with long-term follow-up are required to assess the clinical outcomes of both nonoperatively and operatively treated pediatric pelvic fractures and to guide both triage and treatment decisions for these rare but severe injuries. Level of Evidence: Level III

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management

Igboechi

Purtell

Carry

et al. 2023

Journal of Pediatric Orthopaedics

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show abstract

“…NSP criteria can help identify when helicopter transport is needed and when that expensive and limited resource is being over-utilized. 11 We cannot stress enough the importance of these pre-hospital decisions. Incorrect triaging leads to inadequate or overutilization of hospital resources.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Need for surgeon presence: Continuing to Re-Think pediatric trauma triage strategies

Esparaz

Russell

2021

The American Journal of Surgery

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Factors Associated With Early Discharge in Pediatric Trauma Patients Transported by Rotor: A Retrospective Analysis

Marlor,

Juang,

Pruitt

et al. 2024

Air Medical Journal

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Helicopter transport in pediatric trauma: A new methodology using Need for Surgeon Presence to evaluate the necessity of air transport

Cited by 6 publications

References 15 publications

Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management

Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management

Need for surgeon presence: Continuing to Re-Think pediatric trauma triage strategies

Factors Associated With Early Discharge in Pediatric Trauma Patients Transported by Rotor: A Retrospective Analysis

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