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  • Title: Effectiveness of a pediatric trauma team protocol.
    Author: Nuss KE, Dietrich AM, Smith GA.
    Journal: Pediatr Emerg Care; 2001 Apr; 17(2):96-100. PubMed ID: 11334102.
    Abstract:
    OBJECTIVE: To determine the effectiveness of a pediatric trauma triage system and resource allocation for emergency medicine and trauma services. TRAUMA SYSTEM: Two-tier trauma team activation system that triages patients into Level 1 and Level 2 trauma alert categories based on information provided by pre-hospital providers to pediatric emergency physicians at an American College of Surgeons' Level 1 pediatric trauma center in Columbus, Ohio. METHODS: Using the hospital trauma registry database and patient medical records, a retrospective chart review was conducted on all (n = 542) admitted pediatric trauma patients from January 1995 through December 1996. RESULTS: Level 1 patients had a higher median injury severity score and shorter emergency department (ED) length of stay time than Level 2 patients. Level 1 patients were more likely to be admitted to the pediatric intensive care unit and remain for more than 24 hours when compared to Level 2 patients. In addition, Level 1 patients were more likely to have procedures performed (eg, intubation, tube thoracostomy, thoracotomy, diagnostic peritoneal lavage) than Level 2 patients. The mortality rate was significantly higher for Level 1 patients and all ED deaths had been triaged to the Level 1 category. CONCLUSIONS: This pediatric trauma triage system effectively predicts which patients will be more likely to have serious injury. By using a two-tier system, select patients may be managed by a smaller trauma team, thus improving staff utilization and possibly reducing costs while ensuring favorable outcomes.
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