Injury prevention and emergency medical services for children in a managed care environment

Moody-Williams, Jean; Athey, Jean; Barlow, Barbara; Blanton, Donald; Garrison, Herbert G.; Mickalide, Angela D.; Miller, Ted R.; Olson, Lenora M.; Skripak, Danielle

doi:10.1016/s0196-0644(00)70075-8

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…1 Each year, 1 in 5 children who live in the United States will be treated for injuries that are a major cause of medical costs for children ages 5 to 21 years and that account for ϳ20% of hospital admissions. 2 Fracture is an outcome of 10% to 27% of all childhood injuries, contributing significantly to the mortality, morbidity, and costs of care. [3][4][5][6] There is an increasing secular trend in the incidence of fractures among children.…”

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confidence: 99%

“…Awareness of these patterns could help emergency physicians to actively look for those injuries in patients and, by prompt and accurate diagnosis of additional injuries, to improve outcomes and decrease medical costs. 16 The goals of this study were (1) to calculate age-, gender-, and race/ethnicity-specific incidence rates of femur fractures; (2) to assess mechanisms of injury that lead to femur fractures; (3) to determine the prevalence of associated injuries among children with femur fractures and the mechanism of injury that leads to specific injury patterns; (4) to explore the relationship between the presence of associated injuries in patients with femur fractures and factors such as survivorship, hospital length of stay (LOS), and Injury Severity Score (ISS); and (5) in a smallarea analysis at the census tract level, to identify potentially modifiable risk factors or subpopulations at highest risk for femur fractures. Socioeconomic factors (eg, income, crowding, marital status) have been shown to affect the rates of injuries.…”

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confidence: 99%

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Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

Rewers¹,

et al. 2005

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ABSTRACT. Objective. The objectives of this study were to determine the incidence of femur fractures in Colorado children, to assess underlying causes, to determine the prevalence and predictors of associated injuries, and to identify potentially modifiable risk factors.Methods. The study population included all Colorado residents who were aged 0 to 17 years at the time of injury between January 1, 1998, and December 31, 2001. Cases of femur fracture were ascertained using the population-based Colorado Trauma Registry and International Classification of Diseases, Ninth Revision, Clinical Modification codes 820.0 to 821.39. Associated injuries with an Abbreviated Injury Scale of 2 or higher were classified into 5 categories. Poisson regression, small area analysis, and multivariate logistic regression were used to identify predictors of femur fractures and associated injuries, respectively.Results. During the study period, 1139 Colorado children (795 boys, 344 girls) sustained femur fractures, resulting in the incidence of 26.0 per 100 000 person-years. Rates were higher in boys than in girls in all age groups (overall risk ratio: 2.19; 95% confidence interval: 1.92-2.47) but did not differ by race/ethnicity. Femur fractures that were caused by nonaccidental trauma showed more distal and combined shaft ؉ distal pattern; their incidence did not differ by gender or race but was higher in census tracts with more single mothers and less crowded households. Associated injuries were present in 28.6% of the cases, more often in older children. Fatalities occurred only among children with associated injuries. Children who were involved in nonaccidental trauma, motor vehicle crashes, or auto-pedestrian accidents were 16 to 20 times more likely to have associated injuries than those with femur fractures as a result of a fall. In smallarea analysis, the incidence of femur fractures in infants and toddlers was higher in census tracts characterized by higher proportion of Hispanics, single mothers, and more crowded households. Among children 4 to 12 years of age, the incidence was higher in census tracts with fewer single-family houses and more crowded households. Finally, the incidence of femur fractures among teenagers was higher in rural tracts and those with a higher proportion of Hispanics. Conclusions

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Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

Rewers¹,

et al. 2005

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“…grupo de condições que exige atenção médica, além de gerar mais de 20% das admissões e dias de internação hospitalar 9 .…”

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Initial assessment and transportation of an injured child

Schvartsman¹,

Carrera²,

Abramovici³

2005

J Pediatr (Rio J)

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Como citar este artigo: Schvartsman C, Carrera R, Abramovici S. Avaliação e transporte da criança traumatizada. J Pediatr (Rio J). 2005;81(5 Supl):S223-S229. AbstractObjectives: Since trauma has a great impact on mortality and preventable morbidity among children and adolescents, in addition to its social consequences, the aim of this study is to evaluate peculiarities regarding prehospital, in-hospital, and interhospital assessment of injured pediatric patients. Sources of data:The Cochrane database was searched for systematic reviews and controlled trials, the MEDLINE and LILACS databases were used for the last 5 years, and review of older reference sections in significant publications using trauma, pediatric trauma, primary survey, secondary survey, in-hospital assessment, prehospital and transportation as keywords.Summary of the findings: There are different strategies that constitute the systematic assessment of the injured pediatric patient. Nevertheless, almost all strategies involve knowing the peculiarities about the pediatric population, with regard to age, to the growth and development process, and finally, to the minimally acceptable and available resources. Conclusions:The most important principle is to do no further harm. If the peculiarities about airway maintenance, ventilation, circulation with hemorrhage control, disability, exposure up to secondary survey and preparation of prehospital and interhospital transportation are properly taken care of, better results will certainly be obtained.J Pediatr (Rio J). 2005;81(5 Supl):S223-S229: Trauma, pediatric trauma, primary survey, secondary survey, in-hospital assessment, prehospital and interhospital transportation. ResumoObjetivos: Devido ao impacto determinado pelo trauma na população infanto-juvenil no que diz respeito à mortalidade, morbidade e conseqüências sociais geradas, nossos objetivos concentram-se nas peculiaridades da avaliação pré-hospitalar, em ambiente hospitalar e ainda durante o transporte do paciente traumatizado pediátrico. Fontes de dados:Pesquisa eletrônica realizada nas bases Cochrane para revisões sistemáticas e estudos controlados, MEDLINE e LILACS nos últimos 5 anos e revisão de referências anteriores em publicações significativas, utilizando as seguintes palavras-chave: trauma, trauma pediátrico, exame primário, exame secundário, atendimento hospitalar, transporte pré-hospitalar e inter-hospitalar.Síntese dos dados: Diferentes estratégias compõem a sistematização do atendimento de crianças e adolescentes traumatizados. Entretanto, quase todas comportam a necessidade de conhecer as particularidades da população a ser tratada, no que diz respeito à idade, ao processo de crescimento e desenvolvimento e, finalmente, compondo o atendimento com os recursos minimamente aceitáveis e disponí-veis.Conclusões: O princípio de maior importância diz respeito a não determinar lesão adicional. Mantendo a visão sistemática das diferentes peculiaridades quanto à abordagem das vias aéreas, ventilação, circulação com controle de hemorragias, e...

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“…Traumatic injuries constitute the major group of diseases that requires medical care, being accountable for over 20% of hospital admissions and days spent in a hospital. 9 In our setting, External Causes play a crucial role in mortality of children aged between 1 and 14 years, and determine representative morbidity, with a significant number of admissions/year and considerable hospital costs. 10 Treatment of traumatized children starts at the scene of injury with the arrival of the prehospital care team, their evaluation and approach, followed by the transport to an appropriate hospital unit, preferably the one closest to the scene.…”

Section: Introductionmentioning

confidence: 97%

Avaliação e transporte da criança traumatizada

Schvartsman

Carrera²,

Abramovici³

2005

J. Pediatr. (Rio J.)

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Suggested citation: Schvartsman C, Carrera R, Abramovici S. Initial assessment and transportation of an injured child. J Pediatr (Rio J). 2005;81(5 Suppl):S223-S229. AbstractObjectives: Since trauma has a great impact on mortality and preventable morbidity among children and adolescents, in addition to its social consequences, the aim of this study is to evaluate peculiarities regarding prehospital, in-hospital, and interhospital assessment of injured pediatric patients. Sources of data:The Cochrane database was searched for systematic reviews and controlled trials, the MEDLINE and LILACS databases were used for the last 5 years, and review of older reference sections in significant publications using trauma, pediatric trauma, primary survey, secondary survey, in-hospital assessment, prehospital and transportation as keywords.Summary of the findings: There are different strategies that constitute the systematic assessment of the injured pediatric patient. Nevertheless, almost all strategies involve knowing the peculiarities about the pediatric population, with regard to age, to the growth and development process, and finally, to the minimally acceptable and available resources. Conclusions:The most important principle is to do no further harm. If the peculiarities about airway maintenance, ventilation, circulation with hemorrhage control, disability, exposure up to secondary survey and preparation of prehospital and interhospital transportation are properly taken care of, better results will certainly be obtained.J Pediatr (Rio J). 2005;81(5 Suppl):S223-S229: Trauma, pediatric trauma, primary survey, secondary survey, inhospital assessment, prehospital and interhospital transportation.

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Injury prevention and emergency medical services for children in a managed care environment

Cited by 13 publications

References 14 publications

Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

Childhood Femur Fractures, Associated Injuries, and Sociodemographic Risk Factors: A Population-Based Study

Initial assessment and transportation of an injured child

Avaliação e transporte da criança traumatizada

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