Citation

Recicar J, Barczyk A, Duzinski S, Lawson KA, Garcia NM, Letton R, Raines AR, Eubanks JW, Azarakhsh N, Grimes S, Notrica DM, Garcia-Fillon P, Alder A, Greenwell C, Megison S, Rettiganti M, Luo C, Maxson RT. J. Pediatr. Surg. 2015; 51(2): 319-322.

Affiliation

Division of Pediatric Surgery, Department of Surgery, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, AR, USA. Electronic address: rtmaxson@uams.edu.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2015.10.041

PMID

26781065

Abstract

PURPOSE: Restraint status has not been combined with mechanistic criteria for trauma team activation. This study aims to assess the relationship between motor vehicle crash rollover (MVC-R) mechanism with and without proper restraint and need for trauma team activation.

METHODS: Patients <16years old involved in an MVC-R between November 2007 and November 2012 at 6 Level 1 pediatric trauma centers were included. Restraint status, the need for transfusion or intervention in the emergency department (ED), hospital and intensive care length of stay and mortality were assessed.

RESULTS: Of 690 cases reviewed, 48% were improperly restrained. Improperly restrained children were more likely to require intubation (OR 10.24; 95% CI 2.42 to 91.69), receive blood in the ED (OR 4.06; 95% CI 1.43 to 14.17) and require intensive care (ICU) (OR; 3.11; 95% CI 1.96 to 4.93) than the properly restrained group. The improperly restrained group had a longer hospital length of stay (p<0.001), and a higher mortality (3.4% vs. 0.8%; OR 4.09; 95% CI 1.07 to 23.02) than the properly restrained group.

CONCLUSION: Unrestrained children in MVC-R had higher injury severity and were significantly more likely to need urgent interventions compared to properly restrained children. This supports a modification to include restraint status with the rollover criterion for trauma team activation.

Language: en