Pediatric major resuscitation—respiratory compromise as a criterion for mandatory surgeon presence

Edil, Barish H.; Tuggle, David W.; Jones, Susan; Albrecht, Roxie M.; Kuhn, Ann Pulling; Mantor, P. Cameron; Puffinbarger, Nikola K.

doi:10.1016/j.jpedsurg.2005.03.006

Cited by 11 publications

(5 citation statements)

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“…Edil et al evaluated the relevance of adult major resuscitation criteria in pediatric patients and deduced that respiratory distress was the only appropriate indicator for major resuscitation in children. 5 However, the evaluation of RR and GCS in our study revealed low sensitivity and specificity. This renders their application as a triage tool or trauma activation criteria untenable.…”

Section: Discussioncontrasting

confidence: 67%

“…Glasgow Coma Scale (GCS) and respiratory rate (RR) both have been shown to predict severe injury and adverse outcomes in trauma patients. [4][5][6] They are also incorporated as variables in numerous trauma scoring systems such as Revised Trauma Score, 7 Prehospital Index, 8 CRAMS (Circulation, Respiration, Abdomen, Motor, Speech), 9 MGAP(mechanism, GCS, age, arterial pressure) 10 and BIG (base excess, INR, GCS). 11 Most pediatric trauma centers adopt the "trauma team" concept that activates an immediate assembly of a multidisciplinary team in response to the arrival of injured child.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Trauma Team Activation: Are We Making the Right Call?

et al. 2013

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Section: Discussioncontrasting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Pediatric Trauma Team Activation: Are We Making the Right Call?

et al. 2013

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“…5,8-10,16,17,21 A number of studies evaluated the accuracy of criteria categories including mechanism 6,8,18,19 and physiologic criteria 2 as well as simplified criteria including only respiratory compromise and intubation. 12 Two studies evaluated variations of the Pediatric Trauma Score, 11,15 and 2 studies applied the current ACS criteria to the trauma population. 14,20 The included articles spanned 20 years, and 13,184 children meeting the trauma activation criteria were included.…”

Section: Resultsmentioning

confidence: 99%

“…Some published criteria depended heavily on anatomic factors to identify trauma team activation criteria including 14 specific injuries, 2 but 6 criteria included no anatomic factors at all. 6,7,12-14,18…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Hospital Trauma Team Activation Criteria for Children

Drendel¹,

Gray²,

Lerner

2019

Pediatr Emer Care

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Objectives: Hospital trauma activation criteria are intended to identify children who are likely to require aggressive resuscitation or specific surgical interventions that are time sensitive and require the resources of a trauma team at the bedside. Evidence to support criteria is limited, and no prior publication has provided historical or current perspectives on hospital practices toward informing best practice. This study aimed to describe the published variation in (1) highest level of hospital trauma team activation criteria for pediatric patients and (2) hospital trauma team membership and (3) compare these finding to the current ACS recommendations. Methods: Using an Ovid MEDLINE In-Process & Other Non-Indexed Citations search, any published description of hospital trauma team activation criteria for children that used information captured in the prehospital setting was identified. Only studies of children were included. If the study included both adults and children, it was included if the number of children assessed with the criteria was included. Results: Eighteen studies spanning 20 years and 13,184 children were included. Hospital trauma team activation and trauma team membership were variable. Nearly all (92%) of the trauma criteria used physiologic factors. Penetrating trauma (83%) was frequently included in the trauma team activation criteria. Mechanisms of injury (52%) were least likely to be included in the highest level of activation. No predictable pattern of criterion adoption was found. Only 2 of the published criteria and 1 of published trauma team membership are consistent with the current American College of Surgeons recommendations. Conclusions: Published hospital trauma team activation criteria and trauma team membership for children were variable. Future prospective studies are needed to define the optimal hospital trauma team activation criteria and trauma team membership and assess its impact on improving outcomes for children.

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“…Furthermore, eliminating mechanism-based triage criteria for blunt trauma has been shown to be safe in children [14]. Intubation and respiratory derangement, including tachypnea, predicted outcome for pediatric blunt trauma patients [15] and battlefield trauma victims [16], but not the necessity for surgical trauma team activation (S-TTA) [17,18]. Thus, adequate criteria that predict both outcome and the need for S-TTA have yet to be fully developed.…”

mentioning

confidence: 99%