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Drug use and screening in pediatric trauma
Kathryn L Martin1, Kelly N Vogt, Murray J Girotti
1Division of General Surgery, Department of Surgery, London Health Sciences Center, London, Ontario, Canada. kmartin2008@meds.uwo.ca
Therapeutic Drug Monitoring
|July 12, 2011
Summary
Pediatric trauma patients show sporadic substance use screening. A universal screening approach is needed to understand the true prevalence of alcohol and drug use in this vulnerable population.
Area of Science:
- Trauma Care
- Pediatric Medicine
- Toxicology
Background:
- Limited research exists on substance use within the pediatric trauma population.
- This study addresses the gap by examining substance use and screening trends in Canadian pediatric trauma cases.
Purpose of the Study:
- To describe trends in substance use and screening among pediatric trauma patients in Canada.
- To identify patterns and prevalence of alcohol and drug use in this demographic.
Main Methods:
- Retrospective review of a major trauma database (April 1999-January 2009).
- Inclusion criteria: patients under 18 with Injury Severity Score (ISS) > 12.
- Data collected: age, gender, ISS, blood alcohol concentration (BAC), and toxicology screen results.
Main Results:
- BAC data available for 799 patients (30% tested, 21% positive).
- Toxicology screens available for 761 patients (7% tested, 44% positive).
- Older children were more likely to be screened for alcohol. Drug screening showed a bimodal distribution, with no screening for ages 4-10. Patients screened had higher ISS. Common substances included alcohol, benzodiazepines, cannabinoids, and opiates.
Conclusions:
- Substance use screening in pediatric trauma patients is inconsistent.
- A universal screening approach is recommended to accurately determine the prevalence of substance use in this population.
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