Assessment of the activity of Trauma Centers for Children in Poland in 2021

Abstract

Aim: Injuries are dominant causes of death and hospitalization among children and adolescents. In some countries, there are designated pediatric trauma centers (PTCs) that offer multiple levels of care for trauma patients. Our aim is to demonstrate that the criteria in Polish PTCs may not identify a large group of patients with life-threatening conditions, and they may be referred to centers with lower capabilities. Material and methods: We analyzed all trauma patients transported by ambulance to the Emergency Department in Pediatric Teaching Hospital of University Clinical Center of the Medical University of Warsaw in 2021. Results: Out of 981 pediatric trauma patients, 27 qualified for PTC. Key factors determining which children are more likely to qualify for PTC include the influence of alcohol, falls from heights, the need for analgesics, and fluid therapy. Physical examination abnormalities more likely found among patients qualified for PTC were: GCS≤13, abnormal pupillary reaction, abnormal pupil width, seizures, a decrease in systolic blood pressure, abnormal heart rate, and a decrease in oxygen saturation. There is a significant group of patients who do not meet PTC criteria but present a risk to life or health. Conclusions: Only a small number of admitted children met the qualification criteria for PTC. It seems that we should not assess a patient solely based on preestablished criteria, but the universality of this problem requires the creation of a segregation system that would allow access to patients more individually.