A Multidisciplinary Approach to Adverse Drug Events in Pediatric Trauma Patients in an Adult Trauma Center

2009 ◽  
Vol 25 (7) ◽  
pp. 444-446 ◽  
Author(s):  
Michael Kalina ◽  
Glen Tinkoff ◽  
Wendy Gleason ◽  
Paula Veneri ◽  
Gerard Fulda
Keyword(s):  
Trauma Center ◽  
Multidisciplinary Approach ◽  
Adverse Drug Events ◽  
Pediatric Trauma ◽  
Trauma Patients

scholarly journals Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anne K. Misiura ◽  
Autumn D. Nanassy ◽  
Jacqueline Urbine
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Additional Information ◽  
Pelvic Radiographs ◽  
Pelvic Radiograph ◽  
Digital Radiograph ◽  
Urban Level ◽  
Level I ◽  
Pediatric Trauma Center

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.

scholarly journals CT Use in Hospitalized Pediatric Trauma Patients: 15-year Trends in a Level I Pediatric and Adult Trauma Center

Radiology ◽  
2013 ◽  
Vol 267 (2) ◽  
pp. 479-486 ◽  
Author(s):  
Bahman S. Roudsari ◽  
Kevin J. Psoter ◽  
Monica S. Vavilala ◽  
Christopher D. Mack ◽  
Jeffrey G. Jarvik
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Level I

PEDIATRIC TRAUMA PATIENTS IN AN ‘ADULT' TRAUMA CENTER

1993 ◽  
Vol 35 (3) ◽  
pp. 384-393 ◽  
Author(s):  
Michael Rhodes ◽  
Sharon Smith ◽  
Deborah Boorse
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients

Laparoscopy in the Evaluation of Blunt Abdominal Injury in Level-I and II Pediatric Trauma Centers

2022 ◽  
pp. 000313482110335
Author(s):  
Aryan Haratian ◽  
Areg Grigorian ◽  
Karan Rajalingam ◽  
Matthew Dolich ◽  
Sebastian Schubl ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Trauma Center ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Improvement Program ◽  
Blunt Abdominal Injury ◽  
Level Ii ◽  
American College Of Surgeons ◽  
Level I

Introduction An American College of Surgeons (ACS) Level-I (L-I) pediatric trauma center demonstrated successful laparoscopy without conversion to laparotomy in ∼65% of trauma cases. Prior reports have demonstrated differences in outcomes based on ACS level of trauma center. We sought to compare laparoscopy use for blunt abdominal trauma at L-I compared to Level-II (L-II) centers. Methods The Pediatric Trauma Quality Improvement Program was queried (2014-2016) for patients ≤16 years old who underwent any abdominal surgery. Bivariate analyses comparing patients undergoing abdominal surgery at ACS L-I and L-II centers were performed. Results 970 patients underwent abdominal surgery with 14% using laparoscopy. Level-I centers had an increased rate of laparoscopy (15.6% vs 9.7%, P = .019 ); however they had a lower mean Injury Severity Score (16.2 vs 18.5, P = .002) compared to L-II centers. Level-I and L-II centers had similar length of stay ventilator days, and SSIs (all P > .05). Conclusion While use of laparoscopy for pediatric trauma remains low, there was increased use at L-I compared to L-II centers with no difference in LOS or SSIs. Future studies are needed to elucidate which pediatric trauma patients benefit from laparoscopic surgery.

Cervical spine clearance in unconscious pediatric trauma patients: a level l trauma center experience

2019 ◽  
Vol 36 (4) ◽  
pp. 811-817
Author(s):  
Saud Al-Sarheed ◽  
Jawaher Alwatban ◽  
Ali Alkhaibary ◽  
Yaser Babgi ◽  
Waleed Al-Mohamadi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients

Radiologic Imaging in Trauma Patients with Cervical Spine Immobilization at a Pediatric Trauma Center

2019 ◽  
Vol 57 (4) ◽  
pp. 429-436
Author(s):  
Brandi C. Barnes ◽  
Pradip P. Kamat ◽  
Courtney M. McCracken ◽  
Matthew T. Santore ◽  
Michael D. Mallory ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Radiologic Imaging ◽  
Pediatric Trauma Center

scholarly journals Characteristics of pediatric thoracic trauma: in view of before and after the establishment of a regional trauma center

2021 ◽  
Author(s):  
Pil Young Jung ◽  
Jae Sik Chung ◽  
Youngin Youn ◽  
Chang Wan Kim ◽  
Il Hwan Park ◽  
...  
Keyword(s):  
Trauma Center ◽  
Traffic Accidents ◽  
Thoracic Trauma ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Efficient Treatment ◽  
Before And After ◽  
Level 1 ◽  
Tissue Recovery

Abstract Purpose Pediatric thoracic trauma differs from those of adult in terms of the small anatomy and rapid tissue recovery. Therefore, it is important to know the characteristics of the pediatric thoracic trauma to improve treatment results. In addition, this study examined the changes in pediatric thoracic trauma features and results from the establishment of a level 1 regional trauma center. Methods Data of 168 patients’ ≤ 15 years old diagnosed with thoracic trauma between 2008 and 2019 were retrospectively analyzed. Results Pedestrian traffic accidents were the most common cause of chest injury. The average injury severity score was 17.1 ± 12.4 and the average pediatric trauma score was 5.6 ± 4.1. Lung contusion was the most common in 134 cases. There were 48 cases of closed thoracostomy. There was one thoracotomy for cardiac laceration, one case for extracorporeal membranous oxygenation, and six cases for embolization. Of all, 25 patients died, providing a mortality rate of 14.9%. In addition, independent risk factors of in-hospital mortality were hemopneumothorax and cardiac contusion. Since 2014, when the level 1 regional trauma center was established, more severely injured thoracic trauma patients came. However, the mortality was similar in the two periods. Conclusions Understanding the clinical features of pediatric thoracic trauma patients can help in efficient treatment. In addition, as the severity of pediatric thoracic trauma patients has increased due to the establishment of the regional trauma center, so pediatric trauma center should be organized in regional trauma center to improve the outcomes of pediatric thoracic trauma.

A Handoff Protocol for Pediatric Trauma Patients at a Rural Level One Trauma Center Reduces Length of Stay

2020 ◽  
pp. 000313482095633
Author(s):  
Evelyn Coile ◽  
Kathryn Bailey ◽  
Eric J. Clayton ◽  
Tatiana R. Eversley Kelso ◽  
Heather MacNew
Keyword(s):  
Length Of Stay ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Before And After ◽  
Ancillary Staff ◽  
Trauma Triage ◽  
Level 1 ◽  
Trauma Surgeons ◽  
Level 1 Trauma Center

Background The management of the pediatric trauma patient is variable among trauma centers. In some institutions, the trauma surgeon maintains control of the patient throughout the hospital stay, while others transfer to a pediatric specialist after the initial evaluation and resuscitation period. We hypothesized that handoff to the pediatric surgeon would decrease the length of stay by more efficient coordination with pediatric subspecialists and ancillary staff. Methods A retrospective review from October 2014 to October 2018 was conducted at our rural level 1 trauma center analyzing the length of stay across all demographics and trauma triage levels before and after institution of a handoff protocol from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window. Further analysis included emergency department (ED) disposition to include the effect of handoff on the length of stay in the setting of a higher post-ED acuity, that is, disposition of monitored beds. Results 1267 patient charts were analyzed and the mean length of stay was reduced by .38 days ( t = 5.92, P < .0005) across all demographics, trauma triage levels, post-ED dispositions, and mechanisms of injury after institution of our handoff protocol. Conclusion Handoff from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window at a rural level 1 trauma center significantly improved the length of stay by .38 ( t = 5.92, P < .0005) among pediatric trauma patients in all demographics, trauma triage activations levels, mechanisms of injury, and post-ED dispositions acuity levels.

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