Physiologically focused triage criteria improve utilization of pediatric surgeon-directed trauma teams and reduce costs

Quality assessment of economic evaluation studies in pediatric surgery: A systematic review

“…For example, the economic evaluation of "surgical trauma team activation" in the Children's Hospital of Nashville showed that the mean hospital charges for the first 24 hours of hospitalization for overtriage were $25,518 ($12,921-$28,341) vs $9729 ($4,756-$23,997) for standard management (p = 0.005.) [49].…”

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

“…At our institution, this took the form of frequent meetings, simulation activities, and an open line of communication at all times ( Table 2). A case for institutional support for these changes can be made from studies showing the potential for substantial economic and resource allocation benefits when surgeon involvement in trauma activations is based on strict physiologic activation criteria [20].…”

“…In light of these considerations, utilizing PEM physicians for minor to moderate trauma resuscitations can allow for reduced pediatric surgery resource utilization for these trauma activations. A key to resource utilization is ensuring that trauma alerts are categorized into appropriate tiers, such as minor and major resuscitations [4,20,21]. All resources should be readily available for major resuscitation when life-and limb-threatening injuries are present [14].…”

Mechanism of injury alone is not justified as the sole indication for computed tomographic imaging in blunt pediatric trauma

“…Dowd et al 17 evaluated 107 pediatric trauma team activations for MOI with no physiologic or anatomic specific injury and reported that no resuscitative or operative interventions were required. Mukherjee et al 20 calculated that by eliminating unnecessary trauma activations in their pediatric population (25 of 150), patients would have saved the hospital $20,000 in cost and the patient $120,000 in charges. This group later modified their institutional protocol for trauma activation based on these observations and reduced their overtriage rate to 12%.…”