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Published on: January 15, 2017
Effectiveness of a pediatric trauma team protocol
K E Nuss1, A M Dietrich, G A Smith
1The Ohio State University College of Medicine and Public Health, Department of Pediatrics, Children's Hospital, Columbus 43205, USA. nussk@pediatrics.ohio-state.edu
Insights
A two-tier pediatric trauma triage system effectively identifies severely injured children. This system optimizes resource allocation and improves outcomes by differentiating between Level 1 and Level 2 trauma alerts.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Healthcare Systems Management
Background:
- Effective triage and resource allocation are critical in pediatric trauma care.
- A standardized system is needed to differentiate severity for optimal patient management.
Purpose of the Study:
- To evaluate the effectiveness of a two-tier pediatric trauma triage system.
- To assess resource allocation for emergency medicine and trauma services.
Main Methods:
- Retrospective chart review of 542 pediatric trauma patients.
- Analysis of data from January 1995 to December 1996.
- Utilized hospital trauma registry and patient medical records.
Main Results:
- Level 1 patients exhibited higher injury severity scores and shorter emergency department (ED) stays.
- Level 1 patients had increased likelihood of pediatric intensive care unit (PICU) admission and longer stays (>24 hours).
- Level 1 patients underwent more procedures, and all ED deaths were in the Level 1 group.
Conclusions:
- The two-tier pediatric trauma triage system accurately predicts severe injuries.
- This system allows for tailored trauma team activation, enhancing staff utilization and potentially reducing costs.
- The system ensures favorable patient outcomes while optimizing resource management.
Objective:
To determine the effectiveness of a pediatric trauma triage system and resource allocation for emergency medicine and trauma services. TRAUMA SYSTEM: Two-tier trauma team activation system that triages patients into Level 1 and Level 2 trauma alert categories based on information provided by pre-hospital providers to pediatric emergency physicians at an American College of Surgeons' Level 1 pediatric trauma center in Columbus, Ohio.
Methods:
Using the hospital trauma registry database and patient medical records, a retrospective chart review was conducted on all (n = 542) admitted pediatric trauma patients from January 1995 through December 1996.
Results:
Level 1 patients had a higher median injury severity score and shorter emergency department (ED) length of stay time than Level 2 patients. Level 1 patients were more likely to be admitted to the pediatric intensive care unit and remain for more than 24 hours when compared to Level 2 patients. In addition, Level 1 patients were more likely to have procedures performed (eg, intubation, tube thoracostomy, thoracotomy, diagnostic peritoneal lavage) than Level 2 patients. The mortality rate was significantly higher for Level 1 patients and all ED deaths had been triaged to the Level 1 category.
Conclusions:
This pediatric trauma triage system effectively predicts which patients will be more likely to have serious injury. By using a two-tier system, select patients may be managed by a smaller trauma team, thus improving staff utilization and possibly reducing costs while ensuring favorable outcomes.
