Differences Between Pediatric & Adult Trauma Centers
There is substantial data showing pediatric trauma centers are better for young children, but evidence for adolescents aged 15-19 is less clear.
clinicalRich Falcone0:14 ↗
A prior Ohio-only study showed no difference in outcomes for 15-19 year olds whether treated at adult or pediatric trauma centers.
epidemiologicalRich Falcone0:14 ↗
The National Trauma Data Bank study included patients aged 15-19 with injury severity scores greater than 25 over a 5-year period, totaling almost 13,000 patients.
epidemiologicalRich Falcone0:14 ↗
51% of severely injured adolescents in the study were treated at adult trauma centers and 49% at pediatric trauma centers.
epidemiologicalRich Falcone0:14 ↗
The median injury severity score (ISS) in the study population was 33.
epidemiologicalRich Falcone0:14 ↗
45% of patients in the study had Glasgow Coma Scale scores less than 8, indicating severe brain injuries.
epidemiologicalRich Falcone0:14 ↗
There was no significant difference in mortality between severely injured adolescents treated at adult versus pediatric trauma centers.
epidemiologicalRich Falcone0:14 ↗
Adolescents treated at adult trauma centers were approximately 81% more likely to have an imaging study performed compared to those at pediatric trauma centers.
epidemiologicalRich Falcone0:14 ↗
Severely injured adolescents had shorter length of stay at pediatric trauma centers compared to adult trauma centers.
epidemiologicalRich Falcone0:14 ↗
Severely injured adolescents had shorter ICU length of stay at pediatric trauma centers compared to adult trauma centers.
epidemiologicalRich Falcone0:14 ↗
More adolescents were discharged to home (as opposed to rehab or skilled nursing facilities) when treated at pediatric trauma centers compared to adult trauma centers.
epidemiologicalRich Falcone0:14 ↗
Mortality is not the most important or reliable outcome for pediatric trauma because most children survive once they reach a hospital.
opinionRich Falcone0:14 ↗
Pediatric trauma centers add value for children even up into the adolescent age range (15-19 years).
opinionRich Falcone0:14 ↗
Adult trauma centers need to achieve equivalent imaging and length of stay practices to pediatric trauma centers for adolescents, since 51% of this population presents to adult facilities.
opinionRich Falcone0:14 ↗
Pediatric trauma centers can achieve equivalent outcomes with less imaging by trusting clinical diagnosis and examination, avoiding unnecessary radiation exposure.
clinicalRich Falcone3:15 ↗
A recent study showed that referring hospitals had higher imaging rates than children's hospitals for appendicitis.
epidemiologicalTodd Ponsky2:57 ↗
Pediatric Gun Violence: Pediatric Trauma Series 2017
Over the last 25 years, mortality from pediatric trauma has decreased by about 50%.
epidemiological0:00 ↗
Trauma is still the single most common cause of death in the pediatric population and more common than all other causes combined.
epidemiological0:00 ↗
Among pediatric injury deaths at trauma centers, motor vehicle crashes are the number one cause, followed by firearms and falls (National Trauma Data Bank 2016).
epidemiological0:00 ↗
For children who reach a trauma center, firearms are the most lethal mechanism—the cause most likely to result in death.
clinical0:00 ↗
The number of firearm deaths in the pediatric population now is about the same as at the beginning of this century, showing little progress.
epidemiological0:00 ↗
Among pediatric firearm deaths by intent, homicides are most common, followed by suicide, then unintentional injuries.
epidemiological0:00 ↗
In the 15-19 age group, firearms are responsible for 84% of homicides.
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In the 15-19 age group, firearms are responsible for 46% of suicides.
epidemiological0:00 ↗
In the 15-19 age group, 25% of all deaths involve a firearm.
epidemiological0:00 ↗
Following Sandy Hook, the American Academy of Pediatrics, American College of Surgeons, and American Pediatric Surgical Association reviewed and updated their policy statements on firearm safety and injury prevention.
guideline7:00 ↗
Eight organizations, including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Surgeons, American Psychiatric Association, American Public Health Association, and American Bar Association, published a white paper in the Annals of Internal Medicine advocating multidisciplinary collaboration to reduce firearm injuries.
guideline7:00 ↗
A survey of American College of Surgeons Committee on Trauma members showed that every advocacy topic related to firearms had over 50% support, and nearly half had over 90% support.
epidemiological7:00 ↗
The American Pediatric Surgical Association submitted its firearm policy statement to the entire membership for review and discussion at the annual meeting, resulting in overwhelming approval.
guideline7:00 ↗
Over the last 30-40 years, there has been a 17% reduction in motor vehicle-related deaths and a 77% increase in vehicle miles traveled, while firearm-related deaths increased by 15%.
epidemiological12:00 ↗