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]
Summary
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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