Evaluation of activation criteria in paediatric multi-trauma

Cohen, Neta; Davis, Adrienne L.; Test, Gidon; Singer–Harel, Dana; Pasternak, Yael; Beno, Suzanne; Scolnik, Dennis

doi:10.1093/pch/pxac085

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Intervention-based measures have been found to perform better than the well-established major trauma definition [ 30 , 31 ], including as a means of evaluating TTA criteria [ 32 ]. Centers should review TTA criteria regularly to ensure that they identify patients who will benefit from a trauma team [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Trauma and Trauma Team Activation in a Swiss Pediatric Emergency Department: An Observational Cohort Study

Herren,

Palmer,

Landolt

et al. 2023

Children

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Background. Trauma is one of the most common causes of death in childhood, but data on severely injured Swiss children are absent from existing national registries. Our aim was to analyze trauma activations and the profiles of critically injured children at a tertiary, non-academic Swiss pediatric emergency department (PED). In the absence of a national pediatric trauma database, this information may help to guide the design of infrastructure, processes within organizations, training, and policies. Methods. A retrospective analysis of pediatric trauma patients in a prospective resuscitation database over a 2-year period. Critically injured trauma patients under the age of 16 years were included. Patients were described with established triage and injury severity scales. Statistical evaluation included logistic regression analysis. Results. A total of 82 patients matched one or more of the study inclusion criteria. The most frequent age group was 12–15 years, and 27% were female. Trauma team activation (TTA) occurred with 49 patients (59.8%). Falls were the most frequent mechanism of injury, both overall and for major trauma. Road-traffic-related injuries had the highest relative risk of major trauma. In the multivariate analysis, patients receiving medicalized transport were more likely to trigger a TTA, but there was no association between TTA and age, gender, or Injury Severity Score (ISS). Nineteen patients (23.2%) sustained major trauma with an ISS > 15. Injuries of Abbreviated Injury Scale severity 3 or greater were most frequent to the head, followed by abdomen, chest, and extremities. The overall mortality rate in the cohort was 2.4%. Conclusions: Major trauma presentations only comprise a small proportion of the total patient load in the PED, and trauma team activation does not correlate with injury severity. Low exposure to high-acuity patients highlights the importance of deliberate learning and simulation for all professionals in the PED. Our findings indicate that high priority should be given to training in the management of severely injured children in the PED. The leading major trauma mechanisms were preventable, which should prompt further efforts in injury prevention.

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Section: Discussionmentioning

confidence: 99%

Pediatric Trauma and Trauma Team Activation in a Swiss Pediatric Emergency Department: An Observational Cohort Study

Herren,

Palmer,

Landolt

et al. 2023

Children

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“…An ISS > 15 (the ISS standardizes the severity of traumatic injury based upon anatomical measures [21,22]), and 2. A composite outcome of the patient's need for acute care [19,23,24], which was de ned by ICU admission, direct disposition from the ED to the OR, acute interventions performed in the trauma room (including in-hospital intubation, needle aspiration/ nger thoracotomy/chest tube insertion, blood product administration, pericardiocentesis, central line insertion, performance of cardiopulmonary resuscitation, and resuscitative thoracotomy) or in-hospital death. A severity model was applied to explore predictors for major trauma.…”

Section: Outcome Measurementsmentioning

confidence: 99%

The incidence and severity of pediatric injuries sustained by electric bikes and powered scooters - the experience of an urban, tertiary pediatric emergency department

Moati,

Tavor,

Capua

et al. 2024

Preprint

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Purpose: To describe the incidence and severity of electrical bicycle- (E-bike) and power scooter (P-scooter)-related injuries and their secular trends among pediatric patients presenting to a pediatric emergency department (ED). Methods: This retrospective cohort study of patients aged <18 years who sustained E-bike and P-scooter injuries was performed between 2018 and 2023. We explored trends of severe trauma cases, ED visits, hospitalizations, and surgical interventions. Severity of trauma was rated by either an injury severity score (ISS) >15 or the patient’s need for acute care as defined by intensive care unit (ICU) admission, direct disposition to the operating room, acute interventions performed in the trauma room, and in-hospital death. Results: Of the 1,467 pediatric patients who presented to our pediatric ED following P-scooter and E-bike injuries, 217 (14.8%) were hospitalized, with a median age 14.0 years (interquartile range 10.5–16.0), and male predominance (69.1%). The number of ED visits increased 3.5-fold by study closure, with a parallel increase in hospitalizations, surgical interventions, and severe trauma cases. The relative percentages of severe trauma cases were not significantly different over time, but the mean length of stay in the ICU and the mean number of ventilation days increased significantly during the late period (p=0.02, and p=0.04, respectively). Among hospitalized patients, 3 patients (1.4%) died and 8 (3.7%) required rehabilitation care. Conclusions: The incidence and severity of E-bike and P-scooter injuries and fatalities continue to increase within the pediatric population. Current personal and road safety regulations are failing to alleviate and prevent these injuries and require urgent revision and enforcement.

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Refining triage practices by predicting the need for emergent care following major trauma: the experience of a level 1 adult trauma center

Cohen

Mattar

Feigin

et al. 2022

Eur J Trauma Emerg Surg

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Evaluation of activation criteria in paediatric multi-trauma

Cited by 3 publications

References 27 publications

Pediatric Trauma and Trauma Team Activation in a Swiss Pediatric Emergency Department: An Observational Cohort Study

Pediatric Trauma and Trauma Team Activation in a Swiss Pediatric Emergency Department: An Observational Cohort Study

The incidence and severity of pediatric injuries sustained by electric bikes and powered scooters - the experience of an urban, tertiary pediatric emergency department

Refining triage practices by predicting the need for emergent care following major trauma: the experience of a level 1 adult trauma center

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