Prehospital pediatric trauma classification (PHPTC) as a tool for optimizing trauma care resources in the city of São Paulo, Brazil

Abib, Simone de Campos Vieira; Schettini, Sergio Crescenzo Antonio; Figueiredo, Luiz Francisco Poli de

doi:10.1590/s0102-86502006000100003

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…7 Also physiologic scores, such as RTS have limitations because normal heart and respiratory rates in children are much higher than in adults 26 .…”

Section: ■ Discussionmentioning

confidence: 99%

“…These facts lead to the need of restructuring the system for children, to optimize the treatment of children within the planning trauma system 2,3 . This is also true for disaster scenarios, where the best-trained professionals feel frustrated treating children, there is lack of pediatric equipment in a war scenario, where in addition to the challenges of the care of children, there is the fact that they are often separated from their families 4 .…”

Section: ■ Introductionmentioning

confidence: 99%

“…In Brazil, Abib et al 4 evaluated approximately 13.000 children and adolescents falls are the leading cause of hospitalization (48%), followed by burns (16%), traffic accidents (12%), poisoning (4%), suffocation (1%) 6 . Safe Kids Brazil has accomplished to change laws refering to child safety in Brazil and is reference in the country for Child Safety, having reached a 30% decrease in childhood trauma mortality in 15 years of existence.…”

Section: ■ Introductionmentioning

confidence: 99%

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Unintentional pediatric injuries in São Paulo. How often is it severe?

et al. 2017

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Purpose: To evaluate severity and built a pilot of a national databank about pediatric trauma and to determine its severity. Methods: Prospective study of unintentional pediatric trauma in five hospitals in the city of São Paulo, Brazil. Results: 916 patients in 4 months. 61.5% of traumatized children were male, average 6.5 years. 48. 4% were falls. Most families had an average monthly income less than three minimum wages. 42% of accidents occurred at home. 18.9% of children were alone. 59,8% of parents thought it could be prevented. 26.5% of children had previous accidents. GCS was severe: 5 patients, moderate: 8 patients. 21 patients were intubated (2.4%), RTS <7 in 10.2%, PTS<8 in 3.6%. 8.5% patients were considered severe, which was related to falls (p=0.001); sports (p=0.045); pedestrian (p=0.006); child education (p=0.015) and cared by male (p=0.007). Conclusions: Severity occurred in 8.5% and was associated to falls, sports, traffic, child education, and cared by male. Simple preventive measures could have prevented most of the accidents. The tested tool for details was successful and can be used throughout the country.

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“…7 Also physiologic scores, such as RTS have limitations because normal heart and respiratory rates in children are much higher than in adults 26 .…”

Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

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Unintentional pediatric injuries in São Paulo. How often is it severe?

et al. 2017

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“…Manually obtaining other vital signs in the pediatric population, such as heart rate and blood pressure has been described as challenging. 19 There was good adherence to GCS completion, possibly in part because it was typically scored 15.…”

Section: Differences Among Providers and Adherencementioning

confidence: 99%

Pediatric trauma primary survey performance among surgical and non-surgical pediatric providers in a Brazilian trauma center

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et al. 2020

Trauma Surg Acute Care Open

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IntroductionTrauma is the leading cause of death and disability among Brazilian children and adolescents. Trauma protocols such as those developed by the Advanced Trauma Life Support course are widely taught, but few studies have assessed the degree to which the use of protocolized trauma assessment improves outcomes. This study aims to quantify the adherence of trauma assessment protocols among different types of frontline trauma providers.MethodsA prospective observational study of pediatric trauma care in one of the busiest Latin American trauma centers was conducted during 6 months. Trauma primary survey assessments were observed and adherence to each step of a standardized primary assessment protocol was recorded. Adherence to the assessment protocol was compared among different types of providers, the time of presentation and severity of injury. The relationship between protocol adherence and clinical outcomes including mortality, length of hospital stay, admission to pediatric intensive care unit, use of blood components, mechanical ventilation and number of imaging exams performed in the first 24 hours were also assessed.ResultsEmergency department evaluations of 64 patients out of 274 pediatric admissions were observed over a period of 6 months. 50% of the primary assessments were performed by general surgeons, 34.4% by residents in general surgery and 15.6% by pediatricians. There was an average adherence rate of 34.1% to the trauma protocol. Adherence among each specific step included airway: 17.2%; breathing: 59.4%; circulation: 95.3%; disability: 28.8%; exposure: 18.8%. No differences between specialties were observed. Patients with a more thorough primary assessment underwent fewer CT scans (receiver operating characteristic curve area: 0.661; p=0.027).ConclusionsOur study demonstrates that trauma assessment protocol adherence among trauma providers is low. Thorough initial assessment reduced the use of CT scans suggesting that standardized pediatric trauma assessments may be a way to reduce unnecessary radiological imaging among children.Level of evidenceIV.Study typePediatric and global trauma.

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Systematic review and need assessment of pediatric trauma outcome benchmarking tools for low-resource settings

et al. 2016

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Prehospital pediatric trauma classification (PHPTC) as a tool for optimizing trauma care resources in the city of São Paulo, Brazil

Abstract: Pre-Hospital Pediatric Trauma Classification is a simple and reliable method for assessment, triage and recruitment of pediatric trauma resources.

Cited by 8 publications

References 28 publications

Unintentional pediatric injuries in São Paulo. How often is it severe?

Unintentional pediatric injuries in São Paulo. How often is it severe?

Pediatric trauma primary survey performance among surgical and non-surgical pediatric providers in a Brazilian trauma center

Systematic review and need assessment of pediatric trauma outcome benchmarking tools for low-resource settings

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