Impact of Adult Trauma Center Certification on Pediatric Emergency Trauma Visits

2.50
Hdl Handle:
http://hdl.handle.net/10755/163048
Type:
Presentation
Title:
Impact of Adult Trauma Center Certification on Pediatric Emergency Trauma Visits
Abstract:
Impact of Adult Trauma Center Certification on Pediatric Emergency Trauma Visits
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Kemp, Lynn, RN, BSN, CCRN, CFRN, CEN, NREMT-P
P.I. Institution Name:St. Barnabas Hospital
Title:Trauma Program Manager
Contact Address:4422 Third Avenue, Bronx, NY, 10457, USA
Contact Telephone:(718) 960-6333
Co-Authors:Mary Carmel, RN
Purpose: Nationally, injury is the leading cause of death and disability among children and adults. Trauma
associated deaths result in more years of life lost than cardiac disease and cancer combined. A recently
certified Level I trauma center defined pediatric trauma as patients who are < 18 years of age and fit
ACSCOT (American College of Surgeons Committee on Trauma) criteria for trauma team activation. Level I
trauma centers provide the most comprehensive trauma care and lead the nation in trauma research and
injury prevention activities. Although not designated as a pediatric center, this emergency department (ED)
accommodates both pediatric and adult patients. The effect that certification as a Level I trauma center has
on ED pediatric trauma admissions was conducted to determine the need for additional pediatric equipment,
education, injury prevention initiatives, and resource allocation.
Design: A retrospective comparison study of pediatric patients with trauma-related injuries evaluated in
emergency department prior to and after Level I trauma center certification.
Sample: Pediatric patients with trauma-related injuries identified through ICD coding for ED discharge
diagnoses from August 2000 - March of 2001 (N = 54) and August 2001 - March of 2002 (N = 176).
Methodology: Variables measured included demographics (age, ethnicity, sex, and location of injury -
street vs. highway), Injury Severity Score (ISS), and volume of pediatric trauma patients/month. Pre- and
post-certification variables were compared using Fisher's Exact Test (alpha = 0.05).
Results: Post-certification the number of pediatric trauma and non-trauma patients increased by 225% and
18%, respectively. Evaluation of the monthly number of pediatric trauma patients revealed a significant difference
between the pre- and post-certification groups (p = 0.02). There was no significant difference in
the ISS scores, age, gender, ethnicity, or location of trauma in the two groups.
Conclusions: Although the injury severity was similar pre- and post-certification, the volume of pediatric
trauma patients increased dramatically. Several factors may contribute to this increase: 1) This center evaluates
approximately 50% penetrating trauma, which includes injuries related to stab/gunshot wounds and
impalements. Older adolescents more frequently sustained injuries related to penetrating trauma compared
to younger patients. Emergency medical service personnel and bystanders may consider these adolescents
as adults, either due to body proportion or secondary to the mechanism of injury; 2) Pediatric trauma
patients are frequently transported with multiple victims of the same accident in an attempt to keep families
together; 3) Distance and transport time to a pediatric trauma centers are important factors. In New
York State, there are two regional pediatric trauma centers along with several pediatric emergency departments
and/or pediatric intensive care units in various Level I Trauma Centers; and 4) Pediatric patients are
often driven by family or walk to this urban emergency department, as the local neighborhood is aware of
the new trauma center status. However, patients and their families may not know the difference in adult
and pediatric trauma center designation. This study underscores the need for institutions to apply for adult
and pediatric trauma center certification simultaneously. Dual certification will assist in standardizing and
improving trauma care provided to the pediatric population transported to Level I Trauma Centers. If a
trauma center is not eligible for such certification, adequate pediatric resources should be available to
treat/stabilize pediatric patients and that appropriate transfer policies/procedures should be in place. [Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImpact of Adult Trauma Center Certification on Pediatric Emergency Trauma Visitsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163048-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Impact of Adult Trauma Center Certification on Pediatric Emergency Trauma Visits</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kemp, Lynn, RN, BSN, CCRN, CFRN, CEN, NREMT-P</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Barnabas Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Trauma Program Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">4422 Third Avenue, Bronx, NY, 10457, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(718) 960-6333</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Lynn126@aol.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary Carmel, RN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Nationally, injury is the leading cause of death and disability among children and adults. Trauma<br/>associated deaths result in more years of life lost than cardiac disease and cancer combined. A recently<br/>certified Level I trauma center defined pediatric trauma as patients who are &lt; 18 years of age and fit<br/>ACSCOT (American College of Surgeons Committee on Trauma) criteria for trauma team activation. Level I<br/>trauma centers provide the most comprehensive trauma care and lead the nation in trauma research and<br/>injury prevention activities. Although not designated as a pediatric center, this emergency department (ED)<br/>accommodates both pediatric and adult patients. The effect that certification as a Level I trauma center has<br/>on ED pediatric trauma admissions was conducted to determine the need for additional pediatric equipment,<br/>education, injury prevention initiatives, and resource allocation.<br/>Design: A retrospective comparison study of pediatric patients with trauma-related injuries evaluated in<br/>emergency department prior to and after Level I trauma center certification.<br/>Sample: Pediatric patients with trauma-related injuries identified through ICD coding for ED discharge<br/>diagnoses from August 2000 - March of 2001 (N = 54) and August 2001 - March of 2002 (N = 176).<br/>Methodology: Variables measured included demographics (age, ethnicity, sex, and location of injury -<br/>street vs. highway), Injury Severity Score (ISS), and volume of pediatric trauma patients/month. Pre- and<br/>post-certification variables were compared using Fisher's Exact Test (alpha = 0.05).<br/>Results: Post-certification the number of pediatric trauma and non-trauma patients increased by 225% and<br/>18%, respectively. Evaluation of the monthly number of pediatric trauma patients revealed a significant difference<br/>between the pre- and post-certification groups (p = 0.02). There was no significant difference in<br/>the ISS scores, age, gender, ethnicity, or location of trauma in the two groups.<br/>Conclusions: Although the injury severity was similar pre- and post-certification, the volume of pediatric<br/>trauma patients increased dramatically. Several factors may contribute to this increase: 1) This center evaluates<br/>approximately 50% penetrating trauma, which includes injuries related to stab/gunshot wounds and<br/>impalements. Older adolescents more frequently sustained injuries related to penetrating trauma compared<br/>to younger patients. Emergency medical service personnel and bystanders may consider these adolescents<br/>as adults, either due to body proportion or secondary to the mechanism of injury; 2) Pediatric trauma<br/>patients are frequently transported with multiple victims of the same accident in an attempt to keep families<br/>together; 3) Distance and transport time to a pediatric trauma centers are important factors. In New<br/>York State, there are two regional pediatric trauma centers along with several pediatric emergency departments<br/>and/or pediatric intensive care units in various Level I Trauma Centers; and 4) Pediatric patients are<br/>often driven by family or walk to this urban emergency department, as the local neighborhood is aware of<br/>the new trauma center status. However, patients and their families may not know the difference in adult<br/>and pediatric trauma center designation. This study underscores the need for institutions to apply for adult<br/>and pediatric trauma center certification simultaneously. Dual certification will assist in standardizing and<br/>improving trauma care provided to the pediatric population transported to Level I Trauma Centers. If a<br/>trauma center is not eligible for such certification, adequate pediatric resources should be available to<br/>treat/stabilize pediatric patients and that appropriate transfer policies/procedures should be in place. [Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:40Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:40Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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