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Pediatric injuries in emergency room, Ramathibodi Hospital
A Plitponkarnpim1, S Ruangkanchanasetr, S Thanjira
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Child injuries are common, with falls and transportation accidents being leading causes. While the emergency room triage system shows good accuracy for non-urgent cases, comprehensive data is needed for effective injury prevention strategies.
Area of Science:
- Pediatric Emergency Medicine
- Injury Epidemiology
- Public Health Surveillance
Background:
- Childhood injuries represent a significant public health concern.
- Accurate triage is crucial for effective emergency department resource allocation.
- Understanding injury patterns informs prevention efforts.
Purpose of the Study:
- To analyze pediatric injury epidemiology using emergency room data.
- To evaluate the accuracy of the triage system for child injury cases.
- To identify common causes and risk factors for childhood injuries.
Main Methods:
- Retrospective analysis of computerized emergency room data.
- Inclusion of 14,427 pediatric patients from June 1995 to May 1996.
- Assessment of triage accuracy using negative predictive value.
Main Results:
- 7% of pediatric patients sustained injuries, with a high prevalence in children under 5.
- Falls (38%) and transportation-related incidents (14%) were the most frequent causes.
- The triage system demonstrated a 91% negative predictive value for non-urgent cases.
Conclusions:
- The emergency room-based injury surveillance system effectively describes pediatric injury epidemiology.
- The triage system demonstrates reasonable accuracy in identifying non-urgent cases.
- Enhanced data collection on injury circumstances and environments is vital for injury prevention.
Abstract:
The purposes of this study were to analyze the epidemiological data of child injuries from the computerized data system of the emergency room at Ramathibodi Hospital from June 1995 to May 1996 and assess the accuracy of triage system for child injury cases. Among 14,427 pediatric patients, 1,023 patients (7%) were injured. Most were under 5 years of age (48%), and most were male. Twenty-five per cent of cases were triaged as true emergency cases. Twelve per cent were disposed on an admission or referral by physicians. The negative predictive value of triage system to classify as a non-urgent was 91 per cent. Common causes of injury included falls (38%), inanimate force (19%), transportation (14%), and animal bite (12%). Older age group had significantly more severe injuries than younger (p = 0.002). However, only the transportation injuries were significantly more severe than other types (p = 0.003). The present ER-based injury surveillance system is useful to describe the basic epidemiology of pediatric injuries and to evaluate the triage system. However, for injury prevention purposes, the injury surveillance system should include more data of injury circumstances, associated environment and products.
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