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Development of a Model for Admitting Pediatric Trauma Casualties in the Emergency Department

Published online by Cambridge University Press:  06 May 2019

Raya Tachlizky Madar
Affiliation:
Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel Nursing Administration, Soroka University Medical Center, Beer Sheva, Israel
Bruria Adini
Affiliation:
Department of Disaster Management and Injury Prevention, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv, Israel
David Greenberg
Affiliation:
Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
Avishay Goldberg
Affiliation:
Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Abstract

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Introduction:

Pediatric trauma is one of the leading causes of child mortality and morbidity and is a major challenge for healthcare systems worldwide. Treatment of pediatric trauma requires special attention according to the unique needs of children, especially in children affected by severe trauma who require life-saving treatments. It is essential to examine the preparedness of Emergency Departments (EDs) for admitting and treating pediatric casualties.

Aim:

To develop a model for admitting and treating pediatric trauma casualties in EDs.

Methods:

Seventeen health professionals were interviewed using a semi-structured qualitative tool. A quantitative questionnaire was distributed among general and pediatric EDs’ medical and nursing staff. Following the qualitative and quantitative findings, another round of interviews was performed to identify constraints, to construct a “Current Reality Tree,” and develop a model for admission and management of pediatric casualties in EDs. The model was validated by the National Council for Trauma and Emergency Medicine.

Results:

Lack of uniformity was found regarding age limit and levels of injury of pediatric patients. Most study participants believe that severe pediatric casualties should be concentrated in designated medical centers and that minor and major pediatric casualties should be treated in pediatric rather that general EDs. Pediatric emergency medicine specialists are preferred as case managers for pediatric casualties. Significant diversity in pediatric-care training was found. Based on qualitative and quantitative findings, a model for the optimal admitting and managing of pediatric casualties was designed.

Discussion:

To provide the best care for pediatric casualties and regulate its key aspects, clear statutory guidelines should be formulated at national and local levels. The model developed in this study considers EDs’ medical teams and policy leaders’ perceptions, and hence its significant contribution. Implementation of the findings and their integration in pediatric trauma care in EDs can significantly improve pediatric emergency medical services.

Type
Pediatrics
Copyright
© World Association for Disaster and Emergency Medicine 2019