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A one-year prospective ED cohort of pediatric trauma
L G Yamamoto1, R A Wiebe, W J Matthews
1Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu.
Insights
Pediatric trauma in emergency departments is often unassociated with specific activities, occurring frequently at home. Higher injury severity is linked to motor vehicle accidents, sports, and certain locations.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Research
- Public Health
Background:
- Pediatric trauma represents a significant public health concern.
- Understanding the epidemiology of pediatric trauma is crucial for prevention and intervention.
Purpose of the Study:
- To analyze the causes, locations, and severity of trauma in pediatric patients presenting to an emergency department.
- To identify factors associated with increased injury severity in children.
Main Methods:
- A retrospective review of 4623 pediatric trauma cases (excluding burns) over a 12-month period.
- Data collection included patient demographics, trauma mechanisms, incident locations, injury types, and injury severity scores.
Main Results:
- The majority of pediatric trauma patients were male (61%).
- Common causes included suspected child abuse, sports, and various motor vehicle accidents (MVAs), though 60% had no identified associated activity.
- Incidents occurred primarily at home (41%), on streets (11%), at school (10%), and in parks/playgrounds (10%).
- External body and extremity injuries were most common.
- Higher trauma severity was associated with MVAs, water injuries, sports, streets, schools, parks, playgrounds, skateboards, skates, and alcohol.
Conclusions:
- Pediatric trauma is multifactorial, with a significant portion occurring without specific identified activities.
- Home and street environments are common settings for pediatric injuries.
- Factors such as MVAs, sports, and environmental settings are associated with more severe pediatric trauma.
Abstract:
During a 12-month period ending on November 30, 1988, data were collected on 4623 pediatric patients visiting a pediatric emergency department with trauma (excluding burns). Sixty-one percent were male. Common causes of the trauma included suspected child abuse (4%), organized sports (6%), nonorganized sports (4%), pedestrian motor vehicle accidents (MVAs) (3%), bicycle MVAs (2%), and automobile MVAs (3%). However, most of the incidents had none of the identified associated activities surrounding the trauma (60%). Incidents took place at home (41%), on the street (11%), at school (10%), and at a playground or park (10%). Injuries involved the external body (59%), extremity (26%), head or neck (13%), face (4%), chest (1%), and abdomen (2%) and were more common during the summer. Injury severity scores had a mean of 1.8 and were grouped as: less than 3 (80%), 3-6 (19%), and greater than 6 (1.6%). Factors associated with higher trauma severity included MVAs, water-related injuries, sports, streets, schools, parks, playgrounds, skateboards, skates, and alcohol.