Determining the Association Between Emergency Department Crowding and Debriefing After Pediatric Trauma...

Area of Science:

• Emergency Medicine
• Pediatric Critical Care
• Healthcare Management

Background:

• Debriefing is crucial for pediatric emergency department (PED) team well-being and performance.
• High workload and crowding in PEDs are reported barriers to conducting debriefings.
• This study investigates the link between debriefing incidence and PED crowding after trauma resuscitations.

Purpose of the Study:

• To determine the association between debriefing after pediatric trauma resuscitations and pediatric emergency department crowding.
• To identify factors influencing the implementation of debriefing in a busy pediatric emergency setting.

Main Methods:

• Analysis of 491 Trauma One activations in a PED between April 2018 and December 2019.
• Collected data included debriefing documentation, patient demographics, injury details, and disposition.
• Compared National Emergency Department Overcrowding Scale scores, patient census, and length of stay between resuscitations with and without debriefing.

Main Results:

• Only 10% (50 of 491) of trauma resuscitations had documented debriefing.
• Resuscitations with debriefing had lower overcrowding scores, patient census, and left without being seen rates.
• Debriefing was more common in cases with severe injuries and those resulting in death.

Conclusions:

• Pediatric emergency department crowding is a significant barrier to conducting trauma resuscitation debriefings.
• Severe pediatric trauma and fatalities are strong predictors for conducting debriefings, irrespective of crowding levels.