Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?

Spering, Christopher; Müller, Gerd; Füzesi, L.; Bouillon, Bertil; Rüther, Hauke; Lehmann, Wolfgang; Lefering, Rolf

doi:10.1007/s00068-022-01917-y

Cited by 7 publications

(12 citation statements)

References 20 publications

(47 reference statements)

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“…In pediatric medicine, several registries that include critically ill children have been established to closer monitor subpopulations, e.g., neonates or injured children: The German Neonatal Network (GNN) has strongly influenced neonatal practice by continuously providing evidence on benefits of treatment interventions and unveiling previously unknown associations between risk factors and diseases ( 10 , 25 – 27 ). Likewise, the TraumaRegister DGU® allows in-depth analyses of severely injured children on all aspects of pre-hospital care, shock room management and the subsequent intensive care unit stay ( 28 – 31 ). The impact of the obtained results has reached far beyond scientific purposes but lead to adjustments of emergency care structures and processes.…”

Section: Discussionmentioning

confidence: 99%

Pediatric intensive care unit admissions network—rationale, framework and method of operation of a nationwide collaborative pediatric intensive care research network in Germany

Bruns,

Dohna-Schwake,

Olivieri

et al. 2024

Front. Pediatr.

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The Pediatric Intensive Care Unit Admissions (PIA) network aims to establish a nationwide database in Germany to gather epidemiological, clinical, and outcome data on pediatric critical illness. The heterogeneity of pediatric patients in intensive care units (PICU) poses challenges in obtaining sufficient case numbers for reliable research. Multicentered approaches, such as patient registries, have proven effective in collecting large-scale data. However, Germany lacks a systematic registration system for pediatric intensive care admissions, hindering epidemiological and outcome assessments. The PIA network intends to address these gaps and provide a framework for clinical and epidemiological research in pediatric intensive care. The network will interconnect PICUs across Germany and collect structured data on diagnoses, treatment, clinical course, and short-term outcomes. It aims to identify areas for improvement in care, enable disease surveillance, and potentially serve as a quality control tool. The PIA network builds upon the existing infrastructure of the German Pediatric Surveillance Unit ESPED and utilizes digitalized data collection techniques. Participating units will complete surveys on their organizational structure and equipment. The study population includes patients aged ≥28 days admitted to participating PICUs, with a more detailed survey for cases meeting specific criteria. Data will be collected by local PIA investigators, anonymized, and entered into a central database. The data protection protocol complies with regulations and ensures patient privacy. Quarterly data checks and customized quality reports will be conducted to monitor data completeness and plausibility. The network will evaluate its performance, data collection feasibility, and data quality. Eligible investigators can submit proposals for data analyses, which will be reviewed and analyzed by trained statisticians or epidemiologists. The PIA network aims to improve pediatric intensive care medicine in Germany by providing a comprehensive understanding of critical illness, benchmarking treatment quality, and enabling disease surveillance.

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Section: Discussionmentioning

confidence: 99%

Pediatric intensive care unit admissions network—rationale, framework and method of operation of a nationwide collaborative pediatric intensive care research network in Germany

Bruns,

Dohna-Schwake,

Olivieri

et al. 2024

Front. Pediatr.

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“…above (52.9%). At the age of children, parents are indeed more concerned with the habits and experiences of injuries and driving accidents based on the activities and activities of children during play, this health information that parents are looking for to help in treating their child's initial injuries (Högberg et al, 2019;Spering et al, 2022).…”

Section: Figure 1 Frequency Of Parents In Seeking Children's Health I...mentioning

confidence: 99%

An Overview of Health Issue Tracking among Parents of School-Aged Children

Permana

Ifroh²

2022

aulad

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School age is one of the community groups that is a priority for the national health program. Various health problems of school-age children are a concern of parents. To deal with their school age children's condition, parents require a variety of health issues solutions. Parents commonly prefer to seek for information on their gadgets by using the internet. These many concerns, problems, and issues that parents have about their children's health have motivated an in-depth exploration of parents' digital literacy skills in tracing information. This study aims to determine the frequency with which parents of school-aged children track health information and investigate the issue that 109 parents of school-aged children are interested in based on health issues in East Kalimantan. The sample was chosen using an accidental sampling technique. In this study, a simple questionnaire with closed and open questions was used as a survey method. A univariate and bivariate test were performed to process data on frequency with which parents seek health problems as well as its relationship to respondent characteristics, the Spearman rank test was used. The result is health information about screen time risk was most frequently accessed by parents, but compared to other issues, the nutrition issue is significantly deeper. It will be necessary to develop interventions like health promotion programs that parents will utilize in improving their health literacy, especially about children’s health in the school

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“…Severe abdominal blunt trauma (Abbreviated Injury Severity (AIS) ≥ 3 points) in child passengers of motor vehicle accidents (cMVP) is a rare event [6, 7,9]. Children up to the age of 15 years only represent 3.7 % of the severely injured patients who are documented in the TraumaRegister DGU ® (TR-DGU) [19,[30][31][32]. At the same time motor vehicle accidents have been announced to be the most dangerous factor in a children's environment for many decades, with being the leading cause of death for those under 19 years of age worldwide [18,20,22].…”

Section: Introductionmentioning

confidence: 99%

“…However, current knowledge about child safety seats discusses controversies related to their use especially since the morphology of the accident and the transformation of energy to the pediatric body is important to take into account [2,7,18,38]. Although being restraint in a reboarded seating position, cMVP of 0 -1 years of age are at the highest risk of death (in-hospital mortality rate 15.8 %) [32]. According to a previous investigation in cMVP of the age 0 -5 years, the 0 -1 year old age group showed the signi cantly highest proportion of traumatic brain injuries (TBI) with Glasgow Coma Score (GCS) < 8 and severe injuries to the spine, while the 2-3-year-olds showed the signi cantly highest proportion of fractures especially to the lower extremity and highest proportion of cervical spine injuries of all spine injuries, and the 4-5-year-olds, the signi cantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries.…”

Section: Introductionmentioning

confidence: 99%

“…According to a previous investigation in cMVP of the age 0 -5 years, the 0 -1 year old age group showed the signi cantly highest proportion of traumatic brain injuries (TBI) with Glasgow Coma Score (GCS) < 8 and severe injuries to the spine, while the 2-3-year-olds showed the signi cantly highest proportion of fractures especially to the lower extremity and highest proportion of cervical spine injuries of all spine injuries, and the 4-5-year-olds, the signi cantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries. Severe TBI and injuries to the spine need to be prevented by age, size and body weight related passive security systems such as side-/ head airbags [2,7,15,16,32]. Abdominal injuries as well as injuries to the lower spine and extremities have not been addressed with speci c prevention programs so far.…”

Section: Introductionmentioning

confidence: 99%

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Preventing the Disaster: Severe Abdominal Injury in Child Passengers of Motor Vehicle Accidents often indicate even more serious Trauma.

Spering,

Lefering,

Bieler

et al. 2024

Preprint

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Purpose: The purpose of this study was to evaluate severe abdominal injury in child passengers of different ages of motor vehicle accidents and analyze the concomitant pattern of injury regarding injury severity, trauma management and outcome. Method: Data acquisition was performed using the Trauma Register DGU® (TR-DGU) in a 10-years period (2010–2020) of seriously injured children (maximum AIS 2+ with intensive care) aged 0-15 years of age, as motor vehicle passengers (cMVP) (n = 1,035). Patients primarily treated in or transferred to a German Trauma Center were included. A matched pairs analysis with adult severely injured motor vehicle passengers (aMVP) (age 20-50 years, n = 26,218), matched 1:4 (child: adult), was performed to identify causes of mortality. Results: The study group (cMVP) included 1,035 (10.6%) of 9,751 children, who were seriously injured in road traffic accidents. The mean age within the study population was 9.5 years, 50.5 % were male and the mean Injury Severity Score (ISS) was 18.7 points. Most of the patients (93.0%) were transported from the scene directly to the final trauma center, 7.0 % (n = 72) needed a transfer to another level of trauma care (Level 1 treated 71.0%, Level 2 23.4% and Level 3 5.6% of the children). The transferred patients showed a higher ISS (26 vs. 18 points), higher rate of severe traumatic brain injury (TBI) (AISHead ≥ 3; 49% vs. 33%), a prolonged time to reach the final treating hospital (221 vs. 68 min.), a higher rate of serious abdominal injury (AISAbdomen ≥ 2; 40% vs. 28%) and a higher mortality rate (12.5% vs. 7.4%). The overall mortality rate during hospital stay was 7.0%. About one third (29.3%, n = 303) of the patients showed serious abdominal injury (AISAbdomen ≥ 2). 58% of them showed liver contusions with hematoma, 36% liver lazerations, 36% contusions of the spleen with hematoma and 36% minor and 34% severe lazerations of the spleen. Small bowl contusions with perforation was found in 29%. Most of the severe abdominal injuries occurred after the third year of age with a first peak between 8 – 9 years of age and a second peak in the 14 – 15 years of age group. Serious injuries to the pelvis (AISPlevis ≥ 2) show a similar distribution but less often, the same applies to thoracical injuries but more often than abdominal injuries. Severe brain and head injuries show an antiproportional distribution to the age groups with the highest rate in the 0-1 year old (78%) and the lowest in the 14 – 15 year old (40%). The highest mortality rate was shown in the youngest age groups, related to TBI (AISTBI ≥ 3) 62% in 0-1 years of age. The matched pairs analysis shows a higher mortality rate of cMVP compared to aMVP within the first 24h after hospital admission and a significantly higher rate of patients in shock and unconsciousness, while the intubation rate is significantly lower. The proportion of patients at cardiac arrest is in cMVP higher than in their matched adults. Conclusion: Child passengers of motor vehicle accidents are in need of a more specific and age-related attention towards security systems. The incident of a severe injury is a rare yet life threatening event leading to high mortality rates in the youngest population, especially caused by TBI. But also, severe abdominal and thoracic injuries and their concomitant trauma, need to be prevented and are indicators for even more severe injuries. The management of severely injured child passengers on scene seems to be less progressive than in adults. This also applies for the early diagnostic phase in the Trauma Resuscitation Unit (TRU). Although only 7 % of the children needed a secondary transfer to a higher level of care trauma center, it seems to be favorable for severely injured child passengers of motor vehicle accidents to be directly transported to designated special Level 1 Trauma Centers with sufficient capacity and competency to treat and manage severely injured children, to positively influence their outcome.

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Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?

Cited by 7 publications

References 20 publications

Pediatric intensive care unit admissions network—rationale, framework and method of operation of a nationwide collaborative pediatric intensive care research network in Germany

Pediatric intensive care unit admissions network—rationale, framework and method of operation of a nationwide collaborative pediatric intensive care research network in Germany

An Overview of Health Issue Tracking among Parents of School-Aged Children

Preventing the Disaster: Severe Abdominal Injury in Child Passengers of Motor Vehicle Accidents often indicate even more serious Trauma.

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