The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

Manchev, V; Bruce, J L; Oosthuizen, George; Laing, G L; Clarke, Damian

doi:10.1308/003588414x14055925061595

Cited by 13 publications

(21 citation statements)

References 13 publications

(25 reference statements)

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“…This response must combine curative efforts with prevention strategies. [1][2][3][4][5][6][7][8][9] Primary prevention also needs to be emphasised. Based on this and other SA audits, we need to address the issues of vehiclerelated injuries and interpersonal trauma.…”

Section: Resultsmentioning

confidence: 99%

“…However, the high incidence of assault as a mechanism of blunt trauma reflects the high level of interpersonal violence which is the norm in SA. [1][2][3][4][5][6][7][8][9] There were different injury patterns according to age. Falls seem to occur in the age range of 6 -8-years-old.…”

Section: Discussionmentioning

confidence: 99%

“…Discreet space-occupying lesions such as an extradural or subdural haematoma are less common. [1][2][3][4][5][6][7][8] The need for neurosurgical intervention was low (3.4%). Only a small subset of patients required formal neurosurgical intervention and the vast majority were managed by general surgeons and intensivists.…”

Section: Discussionmentioning

confidence: 99%

“…A public health problem demands a co-ordinated multi-faceted response from a diverse group of stakeholders. [1][2][3][4][5][6][7][8][9][10] South Africa (SA) has successfully mounted such a response to the HIV/AIDS pandemic and has, within a decade, rolled back the situation from one of abysmal and apocalyptic proportions to the management of a widespread chronic disease like diabetes. Hopefully, with continued intervention and the potential development of a vaccine, HIV/AIDS may ultimately be consigned to the history books.…”

Section: Researchmentioning

confidence: 99%

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The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

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The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

et al. 2017

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“…This finding was supported by many previously published studies. 19,25,26,27 Unlike the previous studies 21,22,28 fall was not the most common injury mechanism, rather it was the second most common injury mechanism, 34.0 %( n=238). Vehicle related incidents are the most common injury mechanism in boys and fall is most common in girls.…”

Section: Discussionmentioning

confidence: 61%

Study of the characteristics and burden of pediatric trauma in low resource settings.

Rehman¹,

Makki²,

Fazal

et al. 2020

TPMJ

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Objectives: Purpose of the study is to identify the characteristics and burden of pediatric trauma in a hospital with limited resources and to compare the results with published literature and to formulate the effective injury prevention strategies. Study Design: Prospective, Descriptive, Cross-sectional study. Setting: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2019. Material & Methods: A total of 871 patients aged 12 years and below with a history of trauma were included. The patients were categorized into four age groups, 0-2 years, 3-5 years, 6-8 years, and 9-12 years. Data collected included, age, gender, area (rural/urban), type of injury, mechanism of injury, regional pattern of injury, any intervention required and final outcome. The data were compared in different age groups and both sexes. Results: Out of total 2609 admissions, 871(33.38%) patients were of trauma and burn. 699(80.3%) trauma patients and 172(19.7%) burn patients. The males were 595(67.9%) and females comprised 276(32.1%). Age ranged from 05 days to 12 years (mean5.07years). By age groups, distribution of patients was, 0-2years 201(23.1%), 3-5years 340(39.0%), 6-8years 213(24.5%), and 9-12years 117(13.4%). Blunt trauma was most common type of injury 688(95.56%) and penetrating trauma was 31(4.43%). Most common mechanisms of injury were, vehicle related incidents 380(54.4%) and fall 238(34.0%). The majority of injuries 432(61.8%), were seen in head, neck and face region. Scald was most common type of burn and seen in 125(14.4%) patients. Conclusion: This study clearly shows that pediatric injuries and burn contribute a substantial proportion of all pediatric surgical admissions. Pediatric trauma including burn is a significant burden on health care system. Vehicle related incidents, fall injuries and scald burns are most common type of injuries.

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Surgical Considerations for Pediatric Snake Bites in Low‐ and Middle‐Income Countries

et al. 2019

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Background Snake envenomation is associated with major morbidity especially in low-and middle-income countries and may require fasciotomy. We determined patient factors associated with the need for fasciotomy after venomous snake bites in children located in KwaZulu-Natal, South Africa. Methods Single institutional review of historical data (2012-2017) for children (\18 years) sustaining snake envenomation was performed. Clinical data, management, and outcomes were abstracted. Syndromes after snake bite were classified according to Blaylock nomenclature: progressive painful swelling (PPS), progressive weakness (PW), or bleeding (B), as it is difficult to reliably identify the species of snake after a bite. Comparative and multivariable analyses to determine factors associated with fasciotomy were performed. Results There were 72 children; mean age was 7 (±3) years, 59% male. Feet were most commonly affected (n = 27, 38%) followed by legs (n = 18, 25%). Syndromes (according to Blaylock) included PPS (n = 63, 88%), PW (n =5 , 7%), and B (n = 4, 5%). Eighteen patients underwent fasciotomy, and one required above knee amputation. Nine patients received anti-venom. Few patients (15%) received prophylactic beta-lactam antibiotics. Hemoglobin \ 11 mg/dL, leukocytosis, INR [1.2, and age-adjusted shock index were associated with fasciotomy. On regression, ageadjusted shock index and hemoglobin concentration \ 11 mg/dL, presentation [24 h after snake bite, and INR [1.2 were independently associated with fasciotomy. Model sensitivity was 0.89 and demonstrated good fit. Conclusions Patient factors were associated with the fasciotomy. These factors, coupled with clinical examination, may identify those who need early operative intervention. Improving time to treatment and the appropriate administration of anti-venom will minimize the need for surgery.

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The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

Cited by 13 publications

References 13 publications

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

The spectrum and outcome of paediatric traumatic brain injury in KwaZulu-Natal Province, South Africa has not changed over the last two decades

Study of the characteristics and burden of pediatric trauma in low resource settings.

Surgical Considerations for Pediatric Snake Bites in Low‐ and Middle‐Income Countries

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