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  • Title: Emergency department imaging of pediatric trauma patients during combat operations in Iraq and Afghanistan.
    Author: Naylor JF, April MD, Roper JL, Hill GJ, Clark P, Schauer SG.
    Journal: Pediatr Radiol; 2018 May; 48(5):620-625. PubMed ID: 29307034.
    Abstract:
    BACKGROUND: Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population. OBJECTIVE: The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan. MATERIALS AND METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. We retrieved ED data on ultrasound (US), radiographic and computed tomography (CT) studies. RESULTS: During the study period, there were 3,439 pediatric encounters, which represented 8.0% of all military hospital trauma admissions. ED providers obtained a total of 12,376 imaging studies on 2,920 (84.9%) children. Of the 12,376 imaging studies, 1,341 (10.8%) were US, 4,868 (39.3%) were radiographic and 6,167 (49.8%) were CT exams. Most children undergoing radiographic evaluation were boys (77.8%) and located in Afghanistan (70.4%), and they sustained penetrating injuries (68.0%). Children who underwent imaging had higher composite injury severity scores in comparison to those who did not undergo imaging (10 versus 9). CONCLUSION: Military health care providers frequently utilized radiographic studies in the evaluation of pediatric trauma casualties in Iraq and Afghanistan. Deployed military hospitals that treat children would benefit from dedicated pediatric-specific imaging training and protocols.
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