Managing moderately injured pediatric patients without immediate surgeon presence: 10years later

Boomer, Laura A.; Nielsen, Jason W.; Lowell, Wendi; Haley, Kathy; Coffey, Carla; Nuss, Kathryn E.; Nwomeh, Benedict C.; Groner, Jonathan I.

doi:10.1016/j.jpedsurg.2014.10.041

Cited by 5 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Readmissions are increasingly being scrutinized by public insurers, accountable care 1 organizations, and the American College of Surgeons [1][2][3][4][5][6][7]. Trauma readmissions have been promoted as a quality indicator [2,5,8], and they have been used as a metric to compare patient care approaches and hospital outcomes [9][10][11][12]. Published work has largely focused on adult trauma patient readmissions [5,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

US pediatric trauma patient unplanned 30-day readmissions

Wheeler

Shi

Xiang

et al. 2018

Journal of Pediatric Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

US pediatric trauma patient unplanned 30-day readmissions

Wheeler

Shi

Xiang

et al. 2018

Journal of Pediatric Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…T rauma, which is the most frequent cause of death and disability during childhood, is a preventable condition. [1][2][3][4] There are several types of trauma, such as chemical trauma, thermal trauma, and psychological trauma. Physical trauma can be classified according to blunt or penetrating nature.…”

mentioning

confidence: 99%

Analysis Of Pediatric Traumas; Characteristics And The Role Of Scoring Systems

Aldinc¹

2019

bogazicitip

View full text Add to dashboard Cite

Objectives: Trauma is a major health problem in the pediatric age group. Various etiological factors can be accounted for the traumas, and they cause significant mortality and morbidity in children. Multiple scoring systems have been developed for evaluating trauma patients. The present study aims to investigate to find out which trauma scoring system used in pediatric trauma is superior to others. Methods: This retrospective study was conducted in the Emergency Department of a private university hospital that accepts over 200.000 patients annually. Records of all 20314 trauma cases between 0 and 18 years of age, who were referred to ED of a private university hospital in two years, were searched, and 251 of them who were hospitalized evaluated retrospectively. Demographical, etiological, and clinical characteristics, including scores of five trauma scoring systems, were analyzed. Results: The mean age of the cases was 6.8±5.4 years, 86.9% of the cases had blunt trauma, and 46.9% had isolated head trauma. The most frequent trauma type was falling from a height (57.3%), followed by traffic accidents (25.8%). Mean pediatric trauma score of the patients was 9.41±1.32, mean Glasgow Coma Score was 14.79±0.88, mean Injury Severity Score was 7.74±8.44, mean Revised Trauma Score was 7.84±0, mean Trauma Revised Injury Severity Score blunt was 98.45±7.71 and mean Trauma Revised Injury Severity Score penetrating was 98.61±6.90. The mean duration of the Intensive Care Unit and ward stay was 2.6±3.1 and 1.9±2 days, respectively, and the total duration of hospitalization was 2.2±2.7 days. Conclusion: The trauma scores provide predictive value for clinical severity and treatment in the initial evaluation of cases at admission to the Emergency Department. In this study, we found that Injury Severity Score and Trauma Revised Injury Severity Score are more valuable than the other scoring systems for determining the patient's length of stay in the hospital.

show abstract

Evolving Roles of the Surgeon in the Management of Pediatric Trauma Resuscitation

et al. 2015

Self Cite

View full text Add to dashboard Cite

The traditional paradigm for trauma resuscitations was that a surgeon was always required for leadership. However many changes such as resident work-hour limitations, a shift toward non-operative management, improved trauma triage, and advanced imaging have raised questions about the necessity of a member of the surgical team at all resuscitations. The requirement for surgeon presence is based mostly on opinion rather than data. Our institution has over a decade of experience with pediatric emergency medicine physicians managing minor trauma resuscitations and requiring surgeon presence specifically for the major resuscitations. This has resulted in more appropriate resource allocation without sacrificing patient care in our institution. Other institutions have similarly shifted the focus away from early surgeon involvement while preserving patient safety. We recommend a critical re-evaluation of trauma protocols and systems in requiring surgeon presence as a novel mechanism to improve surgical resource utilization without compromising patient care.

show abstract

Managing moderately injured pediatric patients without immediate surgeon presence: 10years later

Cited by 5 publications

References 10 publications

US pediatric trauma patient unplanned 30-day readmissions

US pediatric trauma patient unplanned 30-day readmissions

Analysis Of Pediatric Traumas; Characteristics And The Role Of Scoring Systems

Evolving Roles of the Surgeon in the Management of Pediatric Trauma Resuscitation

Contact Info

Product

Resources

About