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Does young age merit increased emergency department trauma team response?
James F Holmes1, Ryan Caltagirone1, Maureen Murphy1
1University of California, Davis, School of Medicine, Sacramento, California.
The Western Journal of Emergency Medicine
|January 2, 2014
Summary
Upgrading trauma team response for young children increases medical resource use without reducing missed injuries. This practice is not recommended when emergency department physicians can adequately assess pediatric trauma patients.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Healthcare Resource Management
Background:
- Assessing the impact of enhanced trauma team activation on resource utilization in pediatric blunt trauma.
- Investigating potential benefits for minimally injured children under 6 years old.
Purpose of the Study:
- To determine if increased trauma team response alters resource use in children under 6 years old, particularly those with minor injuries.
- To evaluate the effect on hospitalization rates and missed injuries.
Main Methods:
- Retrospective before-and-after study of children under 6 with blunt trauma.
- Comparison of hospitalization, missed injuries, CT scans, and laboratory tests between upgraded and non-upgraded trauma team responses.
- Analysis focused on patients with Injury Severity Score (ISS) less than 6.
Main Results:
- Increased trauma team response was an independent predictor of hospital admission (OR=5.66).
- Minimally injured patients (ISS <6) in the upgrade group were more likely to undergo CT scans (RR=1.34) and laboratory tests (RR=1.71).
- No cases of missed diagnoses were identified in either group.
Conclusions:
- Enhanced trauma team response in young children leads to increased resource utilization without improving the detection of missed injuries.
- Recommends against increasing trauma team resources solely based on young age in facilities with capable emergency department physicians for pediatric trauma evaluation.
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