A pediatric trauma center without a pediatric surgeon: a four-year outcome analysis. J Trauma 1992 Jul;33(1):130-7; discussion 137-9
Date
07/01/1992Pubmed ID
1635097DOI
10.1097/00005373-199207000-00024Scopus ID
2-s2.0-0026753446 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
Approximately 25% of all injury victims are in the pediatric age group, and one in four injured children will require a pediatric trauma center. According to the American College of Surgeons as well as many state guidelines, a level I pediatric trauma team should be directed by a pediatric surgeon. In 1986, the pediatric surgeon left our pediatric trauma center, but the center remained open under a cooperative effort by the adult trauma surgeons and pediatric intensivists. We have retrospectively reviewed the charts of all pediatric trauma patients (age less than or equal to 15 years) for the subsequent 4 years to determine the outcome of treatment without a pediatric surgeon. During this period, we treated 303 pediatric patients with multiple or serious single-system injuries. The mean age was 6.9 +/- 0.3 (SEM) years and 66% were boys. Falls were the cause of injury in 31% of the patients, with pedestrian/bicycle, motor vehicle crashes, and penetrating injuries resulting in 26%, 19%, and 3% of the injuries, respectively. The mean ISS was 15.6 +/- 0.8, and 73% of the patients had at least one AIS greater than or equal to 3. Surgical procedures were required in 48% of the patients. There were 27 deaths in this group, most commonly related to head injury (89%). The mean Pediatric Trauma Score of the patients who died was 1.6 +/- 0.8 and no patient with a Pediatric Trauma Score greater than 7 died.(ABSTRACT TRUNCATED AT 250 WORDS)
Author List
Fortune JB, Sanchez J, Graca L, Haselbarth J, Kuehler DH, Wallace JR, Edge W, Feustel PJMESH terms used to index this publication - Major topics in bold
AdolescentChild
Child, Preschool
Emergencies
Female
Humans
Infant
Injury Severity Score
Male
Pediatrics
Retrospective Studies
Trauma Centers
Treatment Outcome
Wounds and Injuries
