Paediatric trauma imaging: Why do we need separate guidance?

Negus, Samantha; Danin, J.C.; Fisher, Ross; Johnson, Karl; Landes, Caren; Somers, Jack; Fitzsimmons, Curtis; Ashford, Nick; Foster, Jonathan

doi:10.1016/j.crad.2014.07.001

Cited by 19 publications

(8 citation statements)

References 41 publications

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“…neck and chest) simply for ease; 'the pan scan' unnecessarily exposes children to excess doses of radiation. 5 UK specialist recommendations are that CT is the investigation of choice in significant head and abdominal trauma. For non-penetrating thoracic trauma, CXR will exclude the vast majority of chest injuries particularly if accompanied by CT of the abdomen.…”

Section: Imagingmentioning

confidence: 99%

Paediatric trauma

Fisher

2015

Surgery (Oxford)

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Injury is the commonest cause of death amongst children over the age of 1 year in the developed world. Injury patterns vary across the world. In the UK, paediatric trauma is relatively rare and mainly from blunt injuries. Importantly, the majority of severely injured children are under 10, and more than 25% are less than 1 year of age.Children are anatomically and physically different from adults and their trauma patterns, response and management are also different from those of adults. The evidence shows that children have a better outcome from management under specialist paediatric care.This article covers the principles of trauma management including differences between adult and paediatric management such as volume resuscitation, paediatric trauma imaging and the non-operative approach to solid organ injuries.

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Section: Imagingmentioning

confidence: 99%

Paediatric trauma

Fisher

2015

Surgery (Oxford)

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“…6 This approach differs from standard management of major trauma in adults as it aims to reduce the risk of excessive long-term malignancy from CT radiation exposure. 7 The use of CT in children to deliver cumulative doses of about 50 mGy might almost triple the risk of leukaemia, and at doses of about 60 mGy might triple the risk of brain tumours. 8 What should I start doing?…”

Section: What Do I Need To Know?mentioning

confidence: 99%

NICE clinical guideline NG39: Major trauma: assessment and initial management

Kanani

Hartshorn

2016

Arch Dis Child Educ Pract Ed

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“…In the USA, nearly 90% of children are seen in general emergency departments (EDs) [ 3 ] and many of them are treated in level I or level II adult trauma centers [ 4 ]. The majority of clinicians of all disciplines are understandably anxious when faced with a child presenting to a general ED [ 5 ]. Frequently, these children are treated by providers who lack specialty pediatric training in facilities that have not been modified for the care of children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Perspectives of health professionals on the best care settings for pediatric trauma casualties: a qualitative study

Madar

Adini

Greenberg

et al. 2018

Isr J Health Policy Res

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BackgroundCritically-injured children are frequently treated by providers who lack specialty pediatric training in facilities that have not been modified for the care of children. We set out to understand the attitudes and perspectives of policy makers, and senior nursing and medical managers in the Israeli healthcare system, concerning the provision of medical care to pediatric trauma casualties in emergency departments.MethodsWe conducted semi-structured interviews with 17 health professionals from medical centers across Israel and the Ministry of Health. The interviews were analyzed by qualitative methods.ResultsThere was lack of clarity and uniformity concerning the definition of a pediatric trauma casualty. All of the participants attributed extreme importance to the professional level of the care team manager, and most suggested that this should be a pediatric emergency medicine specialist. They emphasized the importance of around-the-clock availability of pediatric medical teams to care for young trauma casualties, and the crucial need for caregivers to be equipped with a wide variety of professional skills for the adequate treatment of a broad spectrum of injuries. All participants described significant variability in pediatric-care training and experience among physicians and nurses working in emergency departments. Most participants believe that pediatric trauma casualties should be treated in designated pediatric emergency departments, in a limited number of medical centers across the country.ConclusionsOur findings indicate that specialized pediatric EDs would constitute the best location for intake of children with major traumatic injuries. Pediatric emergency medicine specialists should manage trauma cases using pediatric surgeons as ad-hoc consultants. The term ‘pediatric patient’ should be defined to allow trauma patients to be referred to the most appropriate ED. Teams working at these EDs should undergo specialized pediatric emergency medicine training. Finally, to regulate the key aspects of trauma care, clear statutory guidelines should be formulated at national and local levels.

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Paediatric trauma imaging: Why do we need separate guidance?

Cited by 19 publications

References 41 publications

Paediatric trauma

Paediatric trauma

NICE clinical guideline NG39: Major trauma: assessment and initial management

Perspectives of health professionals on the best care settings for pediatric trauma casualties: a qualitative study

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