ISSN - 0973-0958

Pediatric Oncall Journal

Paediatric trauma patients at an adult trauma centre: the kids are all right
Paediatric trauma patients at an adult trauma centre: the kids are all right
Presented in NMPSC 2015, Brighton, UK, 2-3 May 2015
L Clark, M Lazner, C Bevan.
Royal Alexander Children’s Hospital and Freshfield library, Brighton, East Sussex, United Kingdom.
Major trauma is the leading cause of death and disability in children. However, compared to adults, paediatric major trauma (PMT) equates to a very small proportion of total trauma deaths. In 2012, England created the Trauma Network. The Royal Sussex County Hospital (RSCH) is an adult MTC with a paediatric trauma unit on the same campus, the Royal Alexandra Children’s Hospital (RACH). The aim of this study is to review the trauma cases seen at a paediatric trauma unit attached to an adult MTC.
The report is a retrospective review of all trauma patients age <17 years that were directly admitted or transferred to other specialist centres, between 1st August 2013 and the 31st July 2014. It has a particular focus on patients who presented as PMT. Trauma was considered major if, (1) patients were received following a trauma call, (2) patients were identified by Trauma Audit and Research Network (TARN), (3) patients had a significant head injury on imaging.
Of the 4979 paediatric patients analysed approximately 10% were trauma. 43 out of the 491 trauma patients were classified as PMT. 53% of paediatric major trauma patients were male. The median age for paediatric major trauma was 10 years, 2 years older than all paediatric trauma. July was the most common month of admission and 84% of patients presented during the day (09:00-22:00). 67% of PMT patients received a trauma call and 44% of patients had data collected by TARN. The median Index Severity Score for TARN patients was 9. The most common type and mechanism of injury was single fracture injury and fall less than 2m respectively. 18.6% of injuries sustained by children assessed as PMT were soft tissue injuries suggesting patients are being over-triaged. 12% of PMT cases were transferred for further treatment and 100% of patients were alive at discharge, including those transferred, with a median length of stay of 2 nights for those admitted and 0 night for those transferred.
RACH is able to treat the majority of PMT, without the need to transfer. However, over-triaging and collecting current trauma data are still problems for the hospital to overcome.

Cite this article as:
Clark L, Lazner M, Bevan C. Paediatric trauma patients at an adult trauma centre: the kids are all right. Pediatr Oncall J. 2015;12. doi: 10.7199/ped.oncall.2015.6S
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