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Characteristics of a trauma paediatric patient transported by emergency medical services: a retrospective analysis

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Domański M., Michalczewska A., Wierzejska N., Kopczyńska B., Kopczyński M., Konieczny T., Kubiak K., Żyła J., Stachurski J.
Critical Care Innovations
|
2024
|
vol. 7
|
issue 3
11-24
EN
INTRODUCTION: Injuries represent a widespread health problem worldwide and are the leading cause of both mortality and morbidity among children worldwide. This study examines the temporal trends of injured children transported by ambulance with the retrospective analysis of prehospital medical treatment and care. MATERIALS AND METHODS: We analysed all trauma patients transported by ambulance to the Emergency Department in the Paediatric Teaching Hospital of the University Clinical Centre of the Medical University of Warsaw in 2021. Analysis was restricted to a cohort of patients with arrival in ambulances before hospitalisation. A total of 981 patients met these criteria and were included in the analysis. Patient data was analyzed with respect of age, gender, location of the event, trauma mechanism, presence of alcohol or recreational drugs, suspicion of suicide, localisation and character of trauma, vital signs, signs and symptoms, pain assessment, treatment and procedures, and Glasgow Coma Scale (GCS) score. The relationships between the variables were examined using the dependence χ2 test, while the strength was investigated using the Cramer’s V coefficient. RESULTS: Males comprised 58% of the patient population, with a predominance in all age groups. Head trauma was the most frequently diagnosed injury. Accidents were the primary cause of injury, occurring frequently both in domestic and public settings. The specific cause of the injury varied according to the age and gender. A slightly higher volume of patients was observed on weekends and during the day compared to weekdays and regular business hours. Most of the injured children were transported by paramedic emergency medical services. Pain (66.36%) was the most prevalent symptom, followed by bleeding (18.04%). Approximately 6.12% of the patients required hospitalisation for at least 24 hours. The relationship between the child's age and the mechanism of the injuries is statistically significant [χ2 = 290,144; degrees of freedom (df) = 27; p < 0,05] and the association is medium [Cramer’s V coefficient = 0,314]. The relationship between the child's gender and the mechanism of injuries is statistically significant [χ2 = 37,844; degrees of freedom (df) = 9; p < 0,05]. CONCLUSIONS: Severe injuries in children are rare. Boys experience more injuries than girls. A significant portion of injuries occur at home. The mechanism of injury is correlated with age group and gender, but falls from height are the most common. Peak times are during the day and in the summer months, which should be taken into account for personnel planning. The improvement of the safety of children must continue.
2
Publication available in full text mode
Content available

Characteristics of a trauma paediatric patient transported by emergency medical services: a retrospective analysis

100%
Domański M., Michalczewska A., Wierzejska N., Kopczyńska B., Kopczyński M., Konieczny T., Kubiak K., Żyła J., Stachurski J.
Critical Care Innovations
|
2024
|
vol. 7
|
issue 3
11-24
EN
INTRODUCTION: Injuries represent a widespread health problem worldwide and are the leading cause of both mortality and morbidity among children worldwide. This study examines the temporal trends of injured children transported by ambulance with the retrospective analysis of prehospital medical treatment and care. MATERIALS AND METHODS: We analysed all trauma patients transported by ambulance to the Emergency Department in the Paediatric Teaching Hospital of the University Clinical Centre of the Medical University of Warsaw in 2021. Analysis was restricted to a cohort of patients with arrival in ambulances before hospitalisation. A total of 981 patients met these criteria and were included in the analysis. Patient data was analyzed with respect of age, gender, location of the event, trauma mechanism, presence of alcohol or recreational drugs, suspicion of suicide, localisation and character of trauma, vital signs, signs and symptoms, pain assessment, treatment and procedures, and Glasgow Coma Scale (GCS) score. The relationships between the variables were examined using the dependence χ2 test, while the strength was investigated using the Cramer’s V coefficient. RESULTS: Males comprised 58% of the patient population, with a predominance in all age groups. Head trauma was the most frequently diagnosed injury. Accidents were the primary cause of injury, occurring frequently both in domestic and public settings. The specific cause of the injury varied according to the age and gender. A slightly higher volume of patients was observed on weekends and during the day compared to weekdays and regular business hours. Most of the injured children were transported by paramedic emergency medical services. Pain (66.36%) was the most prevalent symptom, followed by bleeding (18.04%). Approximately 6.12% of the patients required hospitalisation for at least 24 hours. The relationship between the child's age and the mechanism of the injuries is statistically significant [χ2 = 290,144; degrees of freedom (df) = 27; p < 0,05] and the association is medium [Cramer’s V coefficient = 0,314]. The relationship between the child's gender and the mechanism of injuries is statistically significant [χ2 = 37,844; degrees of freedom (df) = 9; p < 0,05]. CONCLUSIONS: Severe injuries in children are rare. Boys experience more injuries than girls. A significant portion of injuries occur at home. The mechanism of injury is correlated with age group and gender, but falls from height are the most common. Peak times are during the day and in the summer months, which should be taken into account for personnel planning. The improvement of the safety of children must continue.
PL
WSTĘP: Urazy stanowią powszechny problem zdrowotny na całym świecie i są główną przyczyną zarówno śmiertelności, jak i zachorowalności wśród dzieci na całym świecie. W niniejszym badaniu zbadano trendy czasowe dotyczące dzieci z urazami transportowanych karetką pogotowia z retrospektywną analizą przedszpitalnego leczenia i opieki medycznej. MATERIAŁY I METODY: Przeanalizowano wszystkich pacjentów z urazami transportowanych karetką pogotowia do Oddziału Ratunkowego w Pediatrycznym Szpitalu Klinicznym Uniwersyteckiego Uniwersytetu Medycznego w Warszawie w 2021 r. Analiza została ograniczona do kohorty pacjentów przywiezionych karetkami przed hospitalizacją. Łącznie 981 pacjentów spełniło te kryteria i zostało włączonych do analizy. Dane pacjentów analizowano pod kątem wieku, płci, miejsca zdarzenia, mechanizmu urazu, obecności alkoholu lub narkotyków, podejrzenia samobójstwa, lokalizacji i charakteru urazu, parametrów życiowych, objawów i symptomów, oceny bólu, leczenia i procedur oraz wyniku w skali Glasgow Coma Scale (GCS). Zależności między zmiennymi badano za pomocą testu zależności χ2, natomiast siłę badano za pomocą współczynnika V Cramera. WYNIKI: Mężczyźni stanowili 58% populacji pacjentów, z przewagą we wszystkich grupach wiekowych. Urazy głowy były najczęściej diagnozowanym urazem. Główną przyczyną urazów były wypadki, występujące często zarówno w warunkach domowych, jak i publicznych. Konkretna przyczyna urazu różniła się w zależności od wieku i płci. Nieco większą liczbę pacjentów obserwowano w weekendy i w ciągu dnia w porównaniu z dniami roboczymi i normalnymi godzinami pracy. Większość rannych dzieci została przewieziona przez pogotowie ratunkowe. Ból (66,36%) był najczęstszym objawem, a następnie krwawienie (18,04%). Około 6,12% pacjentów wymagało hospitalizacji przez co najmniej 24 godziny. Zależność między wiekiem dziecka a mechanizmem urazów jest statystycznie istotna [χ2 = 290 144; stopnie swobody (df) = 27; p < 0,05], a związek jest średni [współczynnik V Cramera = 0,314]. Związek płci dziecka z mechanizmem urazów jest statystycznie istotny [χ2 = 37,844; stopnie swobody (df) = 9; p < 0,05]. WNIOSKI: Ciężkie urazy u dzieci zdarzają się rzadko. Chłopcy doznają więcej urazów niż dziewczynki. Znaczna część urazów ma miejsce w domu. Mechanizm urazu jest skorelowany z grupą wiekową i płcią, ale najczęściej zdarzają się upadki z wysokości. Szczytowe okresy to dni i miesiące letnie, co należy uwzględnić przy planowaniu personelu. Poprawa bezpieczeństwa dzieci musi być kontynuowana.
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