Pediatric Trauma: What Hurts?

OBJECTIVES: Pediatric trauma patients are injured during crucial developmental years and require subsequent absence from school and activities. The impact of these changes on pediatric trauma patients is not well studied. We sought to assess the functional and emotional impact of pediatric trauma. In addition, the inpatient experience was evaluated for performance improvement purposes. METHODS: A prospective survey was conducted at our trauma center (February 2019 to May 2019) of admitted trauma patients (<18 years). Patients who died before admission and nonaccidental trauma patients were excluded. Patients completed an inpatient survey and another at 3 months postdischarge. RESULTS: Sixty patients were enrolled; 31 completed follow-up. Patients were 10 ± 5 years, 75% being male (n = 45), with an Injury Severity Score of 7 ± 6. A total of 13% were seen by behavioral medicine while inpatient; 18% of patients had preexisting anxiety. Preexisting functional limitations existed in 7% of the patients. At 3 months, 71% were back to preinjury academics, and 58% had returned to extracurriculars. At follow-up, 10% of patients felt withdrawn, and 32% felt emotional/distracted. Only 13% of patients were undergoing therapy compared with 7% preinjury. Patients communicated their best/worst experiences. CONCLUSION: Pediatric trauma patients experience significant functional and emotional limitations after trauma. This suggests that all pediatric trauma patients should be evaluated by behavioral medicine during their admission with postdischarge support services offered. Performance improvement opportunities were identified in areas of pain control and communication.

Trauma care: an exceptional delivery system.

Systems of trauma care within an institution can vary based on a variety of factors such as patient volume, university affiliation, level of trauma center, and available resources. The trauma care delivery system at Cooper University Hospital allows for a collaborative model that provides a continuum of patient care. High level resuscitations are performed in a dedicated area by a dedicated team supporting efficiency and competency.