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Optimizing Triage Practice in Pediatric Trauma: Lessons From Under-triage and Over-triage Rates and Risk Factors

Lisa C Ngo1, Hayley M Carroll1, Stephanie Salgueiro Massimilian2

  • 1Memorial Regional Hospital, Hollywood, FL, USA.

The American Surgeon
|March 27, 2024
PubMed

Insights

Accurate pediatric trauma triage is crucial. Infants under one year faced higher under-triage, while older children experienced more over-triage, highlighting age-related risks in trauma care.

Area of Science:

  • Pediatric Trauma Care
  • Emergency Medicine
  • Injury Prevention

Background:

  • Accurate triage is critical for effective pediatric trauma care.
  • Unique challenges exist in assessing pediatric trauma severity.
  • Understanding triage inaccuracies is vital for improving outcomes.

Purpose of the Study:

  • To investigate risk factors for under-triage and over-triage.
  • To analyze pediatric trauma activations at an urban trauma center.
  • To identify specific patient groups and injury mechanisms associated with triage errors.

Main Methods:

  • Retrospective cohort study of pediatric trauma activations (<18 years old).
  • Data collected from January 2021 to July 2023 at a Level 1 trauma center.
  • Under- and over-triage identified using trauma activation level and Injury Severity Score.

Main Results:

  • 1094 trauma activations analyzed; under-triage rate 3.8%, over-triage rate 13.6%.
  • Infants (0-1 years) had highest under-triage (10.9%); adolescents (11-17 years) had highest over-triage (17.0%).
  • Non-accidental trauma strongly predicted under-triage (OR 30.2); penetrating mechanisms predicted over-triage (OR 12.2).

Conclusions:

  • Pediatric trauma triage is complex, with distinct age-related patterns.
  • Age, comorbidities, and injury mechanism are key predictive factors.
  • Findings can refine triage practices to enhance pediatric trauma patient care.
Abstract

Keywords:
pediatric surgerytraumatriage

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