Abstract

Trauma is the leading cause of morbidity and mortality in children and adolescents and approximately one third of the injuries are due to a traumatic brain injury (TBI). The impact of prehospital care on the outcome of patients with a TBI has been investigated and it shows a positive impact on better neurological outcome however there are limited research concerning the pediatric patient. Therefore the aim of this study was to describe prehospital care in children with a severe traumatic brain injury. Methods: Retrospective review of prehospital medical records. Results: Most children, 94 percent were brought to the emergency department by ground ambulance due to a severe brain injury. Prehospital interventions were found in one third of the children. Children<7 years received less intervention as compared to older children. The most common prehospital intervention was controlled airway/ endotracheal intubation. Conclusion: Despite a severe brain injury only one third of the children received a prehospital intervention (controlled airway, pain treatment and IV fluid treatment) during the prehospital care. The initial severity of injury showed no impact on the frequencies of interventions.

Highlights

  • IntroductionTrauma is the leading cause of morbidity and mortality in children and adolescents and approximately one third of the injuries are due to a traumatic brain injury (TBI) [1,2]

  • There was no correlation between initial duration of unconsciousness or initial Glasgow Coma Score (GCS) whether the child had received prehospital intervention or not (Chi-2=2.09, df=1, P=0.18)

  • Our research is an attempt to highlight the importance of prehospital interventions concerning children with traumatic brain injuries as stressed by Paediatric Emergency Care Applied Research Network (PRECARN) [17]

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Summary

Introduction

Trauma is the leading cause of morbidity and mortality in children and adolescents and approximately one third of the injuries are due to a traumatic brain injury (TBI) [1,2]. Other prognostic factors for patients with traumatic brain injury has been presented such as Glasgow Coma Score (GCS), pupil reaction, age at injury and head computed (CT) scan findings [11,12]. The impact of prehospital care on the outcome of patients with a traumatic brain injury has investigated in Sweden and the results from Rudehill et al [14] showed a positive impact on postresuscitation neurological status and better neurological outcome because of an effective prehospital care [13]. Result that shows whether this development has had an impact on the prehospital care of the brain-injured child is scarce

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