Interdisciplinary collaborative training for school-based health professionals.

Changes in the nation's health and education systems have mandated that disciplines work together in a coordinated and collaborative manner to meet the complex health and educational needs of children and adolescents. This need for interdisciplinary collaborative training becomes even more of an issue for professionals providing services in school-based health centers. Although several foundation projects have focused on training health care professionals and other service disciplines, there are relatively few reports of interdisciplinary training of school health professionals. Two projects--the California State University Interprofessional Collaboration Training Project and the Catholic University of America School Nurse Practitioner Program--are reviewed and suggestions are presented for expanding interdisciplinary training of school-based health professionals in academic institutions.

Criteria for safe cost-effective pediatric trauma triage: prehospital evaluation and distribution of injured children.

In an effort to maximize staff utilization, all pediatric trauma patients were triaged by emergency room personnel to one of two tiers, based on information reported by prehospital providers over radiotelephones. A total of 952 patients less than 15 years of age were evaluated during a 1-year period. The triage criteria had a sensitivity of 86% in predicting which trauma patients would require operating room and/or pediatric intensive care, while maintaining a specificity of 90%. Fifteen patients died; however, by TRISS methodology there were no unexpected deaths and four unexpected survivors. All eventual deaths were initially captured from field data by the severely injured triage criteria. The study data suggest that physician-controlled two-tiered field triage criteria can safely serve to maximize staff utilization in the emergency room.