Epidemiology of paediatric trauma presenting to US emergency departments: 2006–2012

2017 ◽  
Vol 25 (2) ◽  
pp. 136-143 ◽  
Author(s):  
Jacob B Avraham ◽  
Misha Bhandari ◽  
Spiros G Frangos ◽  
Deborah A Levine ◽  
Michael G Tunik ◽  
...  
Keyword(s):  
Emergency Department ◽  
Children And Adolescents ◽  
Motor Vehicle ◽  
Traumatic Injury ◽  
Case Fatality ◽  
Trauma Centre ◽  
Cost Of Care ◽  
Sample Survey ◽  
Paediatric Trauma ◽  
The Usa

BackgroundTraumatic injury is the leading cause of paediatric morbidity and mortality in the USA. We present updated national data on emergency department (ED) discharges for traumatic injury for a recent 7-year period.MethodsWe conducted a descriptive epidemiological analysis of the Nationwide Emergency Department Sample Survey, the largest and most comprehensive database in the USA, for 2006–2012. Among children and adolescents, we tracked changes in injury mechanism and severity, cost of care, injury intent and the role of trauma centres.ResultsThere was an 8.3% (95% CI 7.7 to 8.9) decrease in the annual number of ED visits for traumatic injury in children and adolescents over the study period, from 8 557 904 (SE=5861) in 2006 to 7 846 912 (SE=5191) in 2012. The case-fatality rate was 0.04% for all injuries and 3.2% for severely injured children. Children and adolescents with high-mortality injury mechanisms were more than three times more likely to be treated at a level 1 trauma centre (OR=3.5, 95% CI 3.3 to 3.7), but were more no more likely to die (OR=0.96, 95% CI 0.93 to 1.00). Traumatic brain injury diagnoses increased 22.2% (95% CI 20.6 to 23.9) during the study period. Intentional assault accounted for 3% (SE=0.1) of all child and adolescent ED injury discharges and 7.2% (SE=0.3) of discharges among 15–19 year-olds. There was an 11.3% (95% CI 10.0 to 12.6) decline in motor vehicle injuries from 2009 to 2012. The total cost of care was $23 billion (SE=0.01), a 78% increase from 2006 to 2012.ConclusionsThis analysis presents a recent portrait of paediatric trauma across the USA. These analyses indicate the important role and value of trauma centre care for injured children and adolescents, and that the most common causes and mechanisms of injury are preventable.

scholarly journals Impaired driving charges in injured impaired drivers requiring treatment in an emergency department

CJEM ◽  
2012 ◽  
Vol 14 (05) ◽  
pp. 290-294 ◽  
Author(s):  
Warren Fieldus ◽  
Ed Cain
Keyword(s):  
Emergency Department ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Trauma Centre ◽  
Motor Vehicle Crash ◽  
Impaired Driving ◽  
Legal Limit ◽  
Vehicle Crash ◽  
Police Records ◽  
The Mean

ABSTRACTObjective:To determine the percentage of injured impaired drivers brought to the only trauma centre in Nova Scotia who were charged with impaired driving.Methods:This retrospective observational study identified alcohol impaired drivers involved in a motor vehicle crash (MVC) brought to the emergency department (ED). Patients were selected based on blood alcohol concentrations (BACs) found to be above the legal limit. Medical records were examined to determine if the patient was the driver in an MVC. Patient records were then cross-referenced with a police database to determine the percentage of injured impaired drivers who were charged with impaired driving.Results:Between April 1, 2006, and April 1, 2008, 1,102 patients brought to the QEII Health Sciences Centre (QEII HSC) ED were found to have BACs over the legal limit. Of these patients, only 57 (5.2%) were found to have been the driver in an MVC. The majority of patients were male (49; 86%), with an average age of 32 years. Most injuries (51; 89.5%) were the result of a single-vehicle crash. The mean Glasgow Coma Scale score was 12.6, and the mean Injury Severity Score was 14.4. Cross-referencing with police records showed that only 22.8% (13 of 57) of injured drivers were charged with impaired driving. Those drivers not charged with impaired driving had a significantly lower median BAC and median age.Conclusion:During the study, the majority of alcoholimpaired drivers injured in an MVC who were brought to the QEII HSC ED for assessment of their injuries were not charged with impaired driving.

scholarly journals Profiles After Acute Traumatic Injury: The Non-battle Injury Impact on Readiness at a Single Military Treatment Facility

2020 ◽  
Author(s):  
Marcos Aranda ◽  
Dana Poloni ◽  
Elisabeth Coffin ◽  
Bryan Hendren
Keyword(s):  
Emergency Department ◽  
Physical Training ◽  
Motor Vehicle ◽  
Traumatic Injury ◽  
Service Members ◽  
Categorical Variables ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Traumatic Injuries ◽  
The Impact

ABSTRACT Introduction Physical profiling is critical to the individual medical readiness of all military service members. This classification system provides detailed information about an individual’s functional abilities. Profile information is used in determining whether a service member is medically deployable or non-deployable. Limited research has been conducted on the impact of acute traumatic injuries on duty status and profiles in the non-deployed setting. The purpose of this study was to characterize injured service members presenting to a CONUS MTF emergency department whose acute traumatic injury resulted in a profile. Materials and Methods A retrospective review of patients who presented to the Dwight D. Eisenhower Army Medical Center emergency department with traumatic injuries from January 1, 2019, to December 31, 2019, was performed. Patients were identified by searching electronic encounter records for trauma-specific ICD-10 codes. Returned patient records were then reviewed for active duty status, branch, age, gender, rank, mechanism, protective equipment, substance use, procedures, and disposition. Profiles of soldiers were reviewed for indication and duration. Patients with profiles were compared to those without profiles. Correlation with age was determined by t-test, correlation with profile length was determined by ANOVA, and correlation with the remaining categorical variables was determined with chi-squared analysis. Results Eight hundred and thirty-two service members were reviewed. One hundred and eight (13%) soldiers had a profile. Patients were 23.2% female with no difference between the two groups. Patients were an average of 28.7 years old. The most common mechanisms were physical training (PT) (33.1%) and falls (12.9%). Physical training and motor vehicle collisions were more common in the profile group. Combatives and crush injuries of the hand were less common in the profile group. Major procedures were more common in the profile group, and minor procedures were less common. Admissions, quarters, immediate referrals, and release without limitations were more common in the profile group. The mean duration of profiles was 48.9 days, and 7.4% were permanent. Conclusions Non-battle injuries in the garrison setting are a significant threat to readiness. This analysis of acute traumatic injuries suggests that mechanism of injury was similar to previous reports with PT and falls being most common. Interventions should be targeted at PT and motor vehicle collisions as these were more common in the profile group. This series is also similar to previous reports that extremity injuries are the most common cause of profiles. However, TBIs were more common in our analysis. Further research that encompasses all garrison MTF acute traumatic injuries is needed to define the true impact on readiness and guide development of injury prevention strategies.

scholarly journals COVID Lockdowns, Social Distancing, and Fatal Car Crashes: More Deaths on Hobbesian Highways?

2020 ◽  
Vol 4 (3-4) ◽  
pp. 238-259 ◽  
Author(s):  
Marshall W. Meyer
Keyword(s):  
World War Ii ◽  
Traffic Safety ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Research Question ◽  
Traffic Volume ◽  
Similar Data ◽  
World War ◽  
Social Distancing ◽  
The Usa

Abstract Research Question What happened to US traffic safety during the first US COVID-19 lockdown, and why was the pattern the opposite of that observed in previous sudden declines of traffic volume? Data National and local statistics on US traffic volume, traffic fatalities, injury accidents, speeding violations, running of stop signs, and other indicators of vehicular driving behavior, both in 2020 and in previous US economic recessions affecting the volume of road traffic. Methods Comparative analysis of the similarities and differences between the data for the COVID-19 lockdown in parts of the USA in March 2020 and similar data for the 2008–2009 global economic crisis, as well as other US cases of major reductions in traffic volume. Findings The volume of traffic contracted sharply once a COVID-19 national emergency was declared and most states issued stay-at-home orders, but motor vehicle fatality rates, injury accidents, and speeding violations went up, and remained elevated even as traffic began returning toward normal. This pattern does not fit post-World War II recessions where fatality rates declined with the volume of traffic nor does the 2020 pattern match the pattern during World War II when traffic dropped substantially with little change in motor vehicle fatality rates. Conclusions The findings are consistent with a theory of social distancing on highways undermining compliance with social norms, a social cost of COVID which, if not corrected, poses potential long-term increases in non-compliance and dangerous driving.

scholarly journals Prehospital resuscitation

2021 ◽  
Vol 6 (1) ◽  
pp. e000729
Author(s):  
Alexandra M P Brito ◽  
Martin Schreiber
Keyword(s):  
Young People ◽  
Tranexamic Acid ◽  
New Technologies ◽  
Blood Product ◽  
Traumatic Injury ◽  
Trauma Patients ◽  
Blood Products ◽  
Front Line ◽  
The Usa ◽  
Review Current

Traumatic injury is the leading cause of death in young people in the USA. Our knowledge of prehospital resuscitation is constantly evolving and is often informed by research based on military experience. A move toward balanced blood product resuscitation and away from excessive crystalloid use has led to improvements in outcomes for trauma patients. This has been facilitated by new technologies allowing more front-line use of blood products as well as use of tranexamic acid in the prehospital setting. In this article, we review current practices in prehospital resuscitation and the studies that have informed these practices.

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