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Pediatric Trauma

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195 papers 500 to 1000 followers
Eric Rosenfeld, Patricio Lau, Wei Zhang, Robert T Russell, Sohail R Shah, Bindi Naik-Mathuria, Adam M Vogel
PURPOSE: The purpose of this study was to identify an optimal definition of massive transfusion (MT) in civilian pediatric trauma. METHODS: Severely injured children (age ≤18 years, injury severity score ≥25) in the Trauma Quality Improvement Program research datasets 2014-2015 that received blood products were identified. Children with traumatic brain injury and non-survivable injuries were excluded. Early mortality was defined as death within 24 h and delayed mortality as death after 24 h from hospital admission...
January 31, 2019: Journal of Pediatric Surgery
Robert L Gates, Mitchell Price, Danielle B Cameron, Stig Somme, Robert Ricca, Tolulope A Oyetunji, Yigit S Guner, Ankush Gosain, Robert Baird, Dave R Lal, Tim Jancelewicz, Julia Shelton, Karen A Diefenbach, Julia Grabowski, Akemi Kawaguchi, Roshni Dasgupta, Cynthia Downard, Adam Goldin, John K Petty, Steven Stylianos, Regan Williams
PURPOSE: The American Pediatric Surgical Association (APSA) guidelines for the treatment of isolated solid organ injury (SOI) in children were published in 2000 and have been widely adopted. The aim of this systematic review by the APSA Outcomes and Evidence Based Practice Committee was to evaluate the published evidence regarding treatment of solid organ injuries in children. METHODS: A comprehensive search strategy was crafted and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were utilized to identify, review, and report salient articles...
January 31, 2019: Journal of Pediatric Surgery
Eric H Rosenfeld, Patricio Lau, Sohail R Shah, Bindi Naik-Mathuria, David E Wesson, Derek S Wakeman, Adam M Vogel
PURPOSE: The purpose of this study was to describe the epidemiology and evaluate the clinical significance of traumatic sternal fractures. METHODS: Patients age ≤18 years with sternal fractures in the National Trauma Database research datasets from 2007-2014 were identified. Patient demographics, injuries, procedures, and outcomes were analyzed using descriptive statistics and logistic regression. RESULTS: Three thousand one hundred sixty patients with sternal fracture were identified...
January 31, 2019: Journal of Pediatric Surgery
Katie W Russell, Micah G Katz, Scott S Short, Eric R Scaife, Stephen J Fenton
INTRODUCTION: Recreation on longboards is gaining in popularity. The purpose of this study is to detail the injury patterns, treatment and management of children with longboarding injuries seen at a level 1 pediatric trauma center. METHODS: A retrospective review using our trauma registry from 2006 to 2016 of pediatric patients who sustained injuries while riding a longboard. RESULTS: Of 12,920 injured children, 64 (0.5%) were treated for injuries that occurred while riding a longboard...
March 2019: Journal of Pediatric Surgery
Paige J Ostahowski, Nithya Kannan, Mark S Wainwright, Qian Qiu, Richard B Mink, Jonathan I Groner, Michael J Bell, Christopher C Giza, Douglas F Zatzick, Richard G Ellenbogen, Linda Ng Boyle, Pamela H Mitchell, Monica S Vavilala
OBJECTIVE Posttraumatic seizure is a major complication following traumatic brain injury (TBI). The aim of this study was to determine the variation in seizure prophylaxis in select pediatric trauma centers. The authors hypothesized that there would be wide variation in seizure prophylaxis selection and use, within and between pediatric trauma centers. METHODS In this retrospective multicenter cohort study including 5 regional pediatric trauma centers affiliated with academic medical centers, the authors examined data from 236 children (age < 18 years) with severe TBI (admission Glasgow Coma Scale score ≤ 8, ICD-9 diagnosis codes of 800...
October 2016: Journal of Neurosurgery. Pediatrics
Brent R O'Neill, Michael H Handler, Suhong Tong, Kevin E Chapman
OBJECT Seizures may cause diagnostic confusion and be a source of metabolic stress after traumatic brain injury (TBI) in children. The incidence of electroencephalography (EEG)-confirmed seizures and of subclinical seizures in the pediatric population with TBI is not well known. METHODS A routine protocol for continuous EEG (cEEG) monitoring was initiated for all patients with moderate or severe TBI at a Level 1 pediatric trauma center. Over a 3.5-year period, all patients with TBI who underwent cEEG monitoring, both according to protocol and those with mild head injuries who underwent cEEG monitoring at the discretion of the treating team, were identified prospectively...
August 2015: Journal of Neurosurgery. Pediatrics
Melissa G Chung, Nicole F O'Brien
OBJECTIVES: To evaluate the prevalence of early seizures after levetiracetam prophylaxis in children with moderate to severe traumatic brain injury. DESIGN: Prospective observational study. SETTING: Level 1 pediatric trauma center. PATIENTS: We enrolled 34 patients between the ages of 0-18 years with moderate to severe traumatic brain injury admitted to the PICU at a level 1 trauma center who received levetiracetam for early posttraumatic seizure prophylaxis...
February 2016: Pediatric Critical Care Medicine
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with posttraumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBIs) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBIs on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Robert W Letton, Veronica Worrell, David W Tuggle
BACKGROUND: Blunt intestinal injury (BII) requiring surgical intervention in the pediatric trauma population remains difficult to diagnose. We sought to analyze whether delay in treatment in the event of perforation had an adverse affect on patient outcome. METHODS: A multi-institutional retrospective chart review by the members of the American Pediatric Surgical Association Committee on Trauma was initiated after the approval of Institutional Review Board at each of the 18 institutions...
April 2010: Journal of Trauma
(no author information available yet)
Injury is still the number 1 killer of children ages 1 to 18 years in the United States ( Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region...
August 2016: Pediatrics
Bridget Lang Findlay, Alexa Melucci, Viktor Dombrovskiy, Joelle Pierre, Yi-Horng Lee
BACKGROUND: Although injury patterns after motor vehicle crashes (MVCs) are well documented, association between adequate restraint and injury severity is unclear. We aimed to determine if improper restraint affects injury rates and severity. METHODS: A retrospective chart review of 477 children hospitalized in Pediatric Trauma Center after MVC was performed. Injuries in various age groups (0-7, 8-12, 13-16, 17-18 years) with different restraint quality measures (proper [PR] and improper/unrestrained [IUR]) as well as injury severity score (ISS: mild [1-9], moderate [10-15], severe [16-25], and profound [>25]) were evaluated and compared...
October 21, 2018: Journal of Pediatric Surgery
Chethan Sathya, Aziz S Alali, Paul W Wales, Jacob C Langer, Brian D Kenney, Randall S Burd, Michael L Nance, Avery B Nathens
BACKGROUND: Trauma is a common indication for computed tomography (CT) in children. However, children are particularly vulnerable to CT radiation and its associated cancer risk. Identifying differences in CT usage across trauma centers and among specific populations of injured children is needed to identify where quality improvement initiatives could be implemented in order to reduce excess radiation exposure to children. We evaluated computed tomography (CT) rates among injured children treated at pediatric (PTC), mixed (MTC), or adult trauma centers (ATC) and estimated the resulting differential in potential cancer risk...
January 2019: Injury
Amy L Baxter, Daniel M Lindberg, Bonnie L Burke, Justine Shults, James F Holmes
OBJECTIVES: Previous research in adult patients with blunt hepatic injuries has suggested a pattern of serum hepatic transaminase concentration decline. Evaluating this decline after pediatric blunt hepatic trauma could establish parameters for estimating the time of inflicted injuries. Deviation from a consistent transaminase resolution pattern could indicate a developing complication. METHODS: Retrospective review of pediatric patients with injuries including blunt liver trauma admitted to one of four urban level 1 trauma centers from 1990 to 2000...
September 2008: Child Abuse & Neglect
Brian R Englum, Brian C Gulack, Henry E Rice, John E Scarborough, Obinna O Adibe
PURPOSE: This study aims to examine the current management strategies and outcomes after blunt pancreatic trauma in children using a national patient registry. METHODS: Using the National Trauma Data Bank (NTDB) from 2007-2011, we identified all patients ≤18years old who suffered blunt pancreatic trauma. Patients were categorized as undergoing nonoperative pancreatic management (no abdominal operation, abdominal operation without pancreatic-specific procedure, or pancreatic drainage alone) or operative pancreatic management (pancreatic resection/repair)...
September 2016: Journal of Pediatric Surgery
Tammy R Kopelman, Ramin Jamshidi, Paola G Pieri, Karole Davis, James Bogert, Sydney J Vail, Daniel Gridley, Melissa A Singer Pressman
PURPOSE: Considering the improvements in CT over the past decade, this study aimed to determine whether CT can diagnose HVI in pediatric trauma patients with seatbelt signs (SBS). METHODS: We retrospectively identified pediatric patients with SBS who had abdominopelvic CT performed on initial evaluation over 5 1/2years. Abnormal CT was defined by identification of any intra-abdominal abnormality possibly related to trauma. RESULTS: One hundred twenty patients met inclusion criteria...
February 2018: Journal of Pediatric Surgery
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason L Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well described in a pediatric trauma cohort. METHODS: This was a prospective analysis of highest level trauma activations in subjects aged 0 to 18 years presenting to our academic center between June 1, 2015, and July 31, 2016, with admission rapid thrombelastograph...
January 2017: Journal of Trauma and Acute Care Surgery
Stephanie Stowman, Christopher A Kearney, Kshama Daphtary
OBJECTIVES: Youth in a PICU and their parents may experience initial symptoms of acute stress disorder and later symptoms of posttraumatic stress disorder. The objective of this study was to examine potential mediators of these conditions, including youth anxiety, depression, negative affect, and hospital fear, as well as parent anxiety and depression DESIGN: This study involved a short longitudinal design that encompassed initial assessments in a PICU setting and later assessments 4-7 weeks after discharge...
May 2015: Pediatric Critical Care Medicine
W B Daviss, R Racusin, A Fleischer, D Mooney, J D Ford, G J McHugo
OBJECTIVE: To examine and identify predictors of acute stress disorder (ASD) and ASD symptomatology (ASDS) in children hospitalized for injuries. METHOD: Fifty-four youths were assessed while hospitalized for injuries. Dependent variables were parent and nurse ratings of children's ASDS. Independent variables included children's prior trauma exposure and behavior problems, injury severity and permanence, brain injury, injury or death to family/friend(s), parental distress, and child reports of the injury/hospitalization experience as meeting criterion A for ASD...
May 2000: Journal of the American Academy of Child and Adolescent Psychiatry
Willie Langeland, Miranda Olff
Research suggests that about a quarter to a third of children with traffic-related injuries develop posttraumatic stress disorder (PTSD). Early symptoms of PTSD have been found to predict poor mental and physical outcome in studies of medically injured children. However, these symptoms are rarely recognized by physicians who provide emergency care for these children. In addition, there is insufficient knowledge about predictors of posttraumatic stress symptoms in this specific pediatric population. Early identification of those children at particular risk is needed to target preventive interventions appropriately...
2008: Neuroscience and Biobehavioral Reviews
Ben Kovachy, Ruth O'Hara, Nate Hawkins, Anda Gershon, Michelle M Primeau, Jessica Madej, Victor Carrion
Many studies have provided strong evidence of a fundamental and complex role for sleep disturbances in adult posttraumatic stress disorder (PTSD). Investigations of adult PTSD using subjective and objective measures document sleep architecture abnormalities and high prevalence of sleep disordered breathing, periodic limb movement disorder, nightmares, and insomnia. PTSD treatment methods do appear to significantly improve sleep disturbance, and also studies suggest that treatments for sleep disorders often result in improvements in PTSD symptoms...
May 15, 2013: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
2017-09-27 23:45:11
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