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01.11.2014 | Original Article

Do prehospital criteria optimally assign injured children to the appropriate level of trauma team activation and emergency department disposition at a level I pediatric trauma center?

verfasst von: Rosemary Nabaweesi, Laura Morlock, Charles Lule, Susan Ziegfeld, Andrea Gielen, Paul M. Colombani, Stephen M. Bowman

Erschienen in: Pediatric Surgery International | Ausgabe 11/2014

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Abstract

Purpose

To examine the association of prehospital criteria with the appropriate level of trauma team activation (TTA) and emergency department (ED) disposition among injured children at a level I pediatric trauma center.

Methods

Injured children younger than 15 years and transported by emergency medical services (EMS) from the scene of injury between January 1, 2008 and December 31, 2011 were identified using the institution’s trauma registry. Logistic regression was used to study the main outcomes of interest, full TTA (FTTA) and ED disposition.

Results

Out of 3,213 children, 1,991 were eligible and analyzed. Only 279 children initiated the FTTA and 73.9 % were admitted. Having a chest injury, abnormal heart rate or Glasgow Coma Scale less than 9 (GCSLT9) in the field was associated with higher odds of initiating the FTTA (odds ratio [OR] = 3.33, 95 % confidence interval [CI] 1.54–7.20; OR = 2.59, CI 1.15–5.79 and OR = 2.67, CI 1.14–6.22, respectively). Children with the criteria above in addition to abdominal injury were more likely to be discharged to the ICU, OR or morgue compared to those without them.

Conclusion

Children with GCSLT9, abnormal heart rate, chest and abdominal injury showed a strong association with FTTA and higher resource utilization.

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Titel: Do prehospital criteria optimally assign injured children to the appropriate level of trauma team activation and emergency department disposition at a level I pediatric trauma center?
verfasst von: Rosemary Nabaweesi
Laura Morlock
Charles Lule
Susan Ziegfeld
Andrea Gielen
Paul M. Colombani
Stephen M. Bowman
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 11/2014
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-014-3587-6

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Do prehospital criteria optimally assign injured children to the appropriate level of trauma team activation and emergency department disposition at a level I pediatric trauma center?