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Thoracoabdominal Trauma

Trauma is the leading cause of morbidity and mortality in children. Children have unique injury patterns and substantial differences in their response to trauma when compared with adults; this requires special consideration when addressing the assessment and management of pediatric trauma.

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Bottom Line Recommendations English (2) French (1) All (3)

Bottom Line Recommendations: Multisystem Trauma

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Beno S, TREKK Network

The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of multisystem trauma in children in the emergency department.

Pediatric Practice Management Guideline: Blunt Abdominal Trauma Evaluation and Management Guideline

Visit

Iowa Methodist Medical Center,

To address the evaluation of pediatric patients presenting acutely after blunt abdominal trauma.

Recommendations de Base: Polytrauma

Download

Beno S, TREKK Network

Le but du present document est de fournir aux professionnels de la sant les faits et recommandations cles pour le diagnostic et le traitement du polytrauma chez les enfants dans un service durgence.

Bottom Line Recommendations: Multisystem Trauma

Download

Beno S, TREKK Network

The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of multisystem trauma in children in the emergency department.

Recommendations de Base: Polytrauma

Download

Beno S, TREKK Network

Le but du present document est de fournir aux professionnels de la sant les faits et recommandations cles pour le diagnostic et le traitement du polytrauma chez les enfants dans un service durgence.

Pediatric Practice Management Guideline: Blunt Abdominal Trauma Evaluation and Management Guideline

Visit

Iowa Methodist Medical Center,

To address the evaluation of pediatric patients presenting acutely after blunt abdominal trauma.

Clinical guidelines English (3) French All (3)

Pediatric Trauma Society Clinical Practice Guidelines

Visit

Pediatric Trauma Society,

These guidelines have been supplied by a hospital as an example of a clinical practice guideline to provide clinicians at that institution with an analytical framework for the evaluation and treatment of a particular diagnosis or condition.

ACR Appropriateness Criteria: Suspected Spine Trauma [see section "Pediatric Patients" starting page 12]

Visit

American College of Radiology,

Clinical guidelines on radiologic procedures for suspected spine trauma.

Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers

Visit

National Cancer Institute,

This page discusses the value of CT and the importance of minimizing the radiation dose, especially in children.

Pediatric Trauma Society Clinical Practice Guidelines

Visit

Pediatric Trauma Society,

These guidelines have been supplied by a hospital as an example of a clinical practice guideline to provide clinicians at that institution with an analytical framework for the evaluation and treatment of a particular diagnosis or condition.

ACR Appropriateness Criteria: Suspected Spine Trauma [see section "Pediatric Patients" starting page 12]

Visit

American College of Radiology,

Clinical guidelines on radiologic procedures for suspected spine trauma.

Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers

Visit

National Cancer Institute,

This page discusses the value of CT and the importance of minimizing the radiation dose, especially in children.

Overviews of systematic reviews English (6) French All (6)

Blood-clot promoting drugs for acute traumatic injury

Visit

Ker K, Robert, I, Shakur H, Coats TJ,

This is an update of an existing Cochrane review, the last version was published in 2012.

Treatment of severe blunt pancreatic lesions in children

Visit

Haugaard MV, Wettergren A, Hillings JG, Gluud C, Penninga L,

This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials.

Preventing death from blood clots, the formation of blood clots and blood clots in the lungs in people who have had physical trauma

Visit

Barrera LM, Perel P, Ker K, Cirocchi R, Farinella E, Morales Uribe CH,

Sixteen studies involving 3,005 people are included in this review.

Should prophylactic antibiotics be used in patients with penetrating abdominal trauma?

Visit

Brand M, Grieve A,

No randomised controlled trials could be found that met the inclusion criteria for this review.

No evidence in favour of using ultrasound to aid diagnosis of patients with a 'blunt' injury to the abdomen

Visit

Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,

This Cochrane Review may be regarded as a review which provides the best available evidence for clinical practice guidelines and management recommendations.

Regular or selected use of computed tomography (CT) scanning to reduce deaths in people who have a high-energy blunt-traumatic injury

Visit

Van Vugt R, Keus F, Kool D, Deunk J, Edwards M,

We searched medical databases for publications of randomised controlled trials (a clinical study where participants are randomly allocated into treatment groups) comparing the usual approach versus selected use of CT scanning.

Blood-clot promoting drugs for acute traumatic injury

Visit

Ker K, Robert, I, Shakur H, Coats TJ,

This is an update of an existing Cochrane review, the last version was published in 2012.

Treatment of severe blunt pancreatic lesions in children

Visit

Haugaard MV, Wettergren A, Hillings JG, Gluud C, Penninga L,

This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials.

Preventing death from blood clots, the formation of blood clots and blood clots in the lungs in people who have had physical trauma

Visit

Barrera LM, Perel P, Ker K, Cirocchi R, Farinella E, Morales Uribe CH,

Sixteen studies involving 3,005 people are included in this review.

Should prophylactic antibiotics be used in patients with penetrating abdominal trauma?

Visit

Brand M, Grieve A,

No randomised controlled trials could be found that met the inclusion criteria for this review.

No evidence in favour of using ultrasound to aid diagnosis of patients with a 'blunt' injury to the abdomen

Visit

Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,

This Cochrane Review may be regarded as a review which provides the best available evidence for clinical practice guidelines and management recommendations.

Regular or selected use of computed tomography (CT) scanning to reduce deaths in people who have a high-energy blunt-traumatic injury

Visit

Van Vugt R, Keus F, Kool D, Deunk J, Edwards M,

We searched medical databases for publications of randomised controlled trials (a clinical study where participants are randomly allocated into treatment groups) comparing the usual approach versus selected use of CT scanning.

Systematic reviews English (9) French All (9)

Avoiding Errors in the Management of Pediatric Polytrauma Patients

Visit

Chin K, Abzug JM, Bae DS, Horn BD, Herman M, Eberson CP,

Lecture on management of pediatric polytrauma patients.

Tranexamic Acid Update in Trauma

Visit

Ramirez RJ, Spinella PC, Bochicchio GV,

This article provides a brief overview of the history of TXA, reviews the known and proposed mechanisms of action, and examines areas of ongoing and future research aimed at addressing unanswered questions.

Massive transfusion in pediatric trauma: We need to focus more on "how"

Visit

Skelton T, Beno S,

Literature review of massive transfusion in pediatric trauma.

Antifibrinolytic drugs for acute traumatic injury

Visit

Ker K, Roberts I, Shakur H, Coats TJ,

Review to assess the effect of antifibrinolytic drugs in patients with acute traumatic injury.

Non-operative versus operative treatment for blunt pancreatic trauma in children

Visit

Haugaard MV, Wettergren,A, Hillings JG, Gluud C, Penninga L,

Review to assess the benefits and harms of operative versus non-operative treatment of blunt pancreatic trauma in children.

Thromboprophylaxis for trauma patients

Visit

Barrera LM, Perel P, Ker K, Cirocchi R, Farinella E, Morales Uribe CH,

Review to assess the effects of thromboprophylaxis in trauma patients on mortality and incidence of deep vein thrombosis and pulmonary embolism and to compare the effects of different thromboprophylaxis interventions and their effects according to the type of trauma.

Prophylactic antibiotics for penetrating abdominal trauma

Visit

Brand M, Grieve A,

Review to assess the benefits and harms of prophylactic antibiotics administered for penetrating abdominal injuries for the reduction of the incidence of septic complications, such as septicaemia, intra-abdominal abscesses and wound infections.

Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma

Visit

Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,

Review to assess the effects of trauma algorithms that include ultrasound examinations in patients with suspected blunt abdominal trauma.

Selective computed tomography (CT) versus routine thoracoabdominal CT for high-energy blunt-trauma patients

Visit

Van Vugt R, Keus F, Kool D, Deunk J, Edwards M,

Review to assess the effects of routine thoracoabdominal CT compared with selective thoracoabdominal CT on mortality in blunt high-energy trauma patients.

Avoiding Errors in the Management of Pediatric Polytrauma Patients

Visit

Chin K, Abzug JM, Bae DS, Horn BD, Herman M, Eberson CP,

Lecture on management of pediatric polytrauma patients.

Tranexamic Acid Update in Trauma

Visit

Ramirez RJ, Spinella PC, Bochicchio GV,

This article provides a brief overview of the history of TXA, reviews the known and proposed mechanisms of action, and examines areas of ongoing and future research aimed at addressing unanswered questions.

Massive transfusion in pediatric trauma: We need to focus more on "how"

Visit

Skelton T, Beno S,

Literature review of massive transfusion in pediatric trauma.

Antifibrinolytic drugs for acute traumatic injury

Visit

Ker K, Roberts I, Shakur H, Coats TJ,

Review to assess the effect of antifibrinolytic drugs in patients with acute traumatic injury.

Non-operative versus operative treatment for blunt pancreatic trauma in children

Visit

Haugaard MV, Wettergren,A, Hillings JG, Gluud C, Penninga L,

Review to assess the benefits and harms of operative versus non-operative treatment of blunt pancreatic trauma in children.

Thromboprophylaxis for trauma patients

Visit

Barrera LM, Perel P, Ker K, Cirocchi R, Farinella E, Morales Uribe CH,

Review to assess the effects of thromboprophylaxis in trauma patients on mortality and incidence of deep vein thrombosis and pulmonary embolism and to compare the effects of different thromboprophylaxis interventions and their effects according to the type of trauma.

Prophylactic antibiotics for penetrating abdominal trauma

Visit

Brand M, Grieve A,

Review to assess the benefits and harms of prophylactic antibiotics administered for penetrating abdominal injuries for the reduction of the incidence of septic complications, such as septicaemia, intra-abdominal abscesses and wound infections.

Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma

Visit

Stengel D, Bauwens K, Rademacher G, Ekkernkamp A, Gthoff C,

Review to assess the effects of trauma algorithms that include ultrasound examinations in patients with suspected blunt abdominal trauma.

Selective computed tomography (CT) versus routine thoracoabdominal CT for high-energy blunt-trauma patients

Visit

Van Vugt R, Keus F, Kool D, Deunk J, Edwards M,

Review to assess the effects of routine thoracoabdominal CT compared with selective thoracoabdominal CT on mortality in blunt high-energy trauma patients.

Key studies English (40) French All (40)

The sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm that minimizes computerized tomography

Visit

Arbuthnot M, Mooney DP,

This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm.

Focused Assessment with Sonography for Trauma (FAST) in Children Following Blunt Abdominal Trauma: A Multi-Institutional Analysis

Visit

Calder BW, Vogel AM, Zhang J, Mauldin PD, Huang EY, Savoie KB, Santore MT, Ts...

A study to investigate the role of FAST for intra-abdominal injury (IAI) and IAI requiring acute intervention (IAI-I) in children after blunt abdominal trauma (BAT).

High ratio plasma resuscitation does not improve survival in pediatric trauma patients

Visit

Cannon JW, Johnson MA, Caskey RC, Borgman MA, Neff LP,

This study sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries.

Consequences of Pediatric Undertriage and Overtriage in a Statewide Trauma System

Visit

Hewes HA, Christensen M, Taillac PP, Mann NC, Jacobsen KK, Fenton SJ,

Study to quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system.

Hypotension and the need for transfusion in pediatric blunt spleen and liver injury: An ATOMAC+ prospective study

Visit

Magoteaux SR, Notrica DM, Langlais CS, Linnaus ME, Raines AR, Letton RW, Alde...

This study sought to determine the relationship between early transfusion in pediatric BLSI and hypotension.

Predictors of Intrathoracic Injury after Blunt Torso Trauma in Children Presenting to an Emergency Department as Trauma Activations

Visit

McNamara C, Mironova I, Lehman E, Olympia RP,

Retrospective chart review to identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature.

Effect of Family Presence on Advanced Trauma Life Support Task Performance During Pediatric Trauma Team Evaluation

Visit

O'Connell KJ, Carter EA, Fritzeen JL, Waterhouse LJ, Burd RS,

We performed a retrospective video review of consecutive pediatric trauma evaluations.

Family Presence During Trauma Resuscitation: Family Members' Attitudes, Behaviors, and Experiences

Visit

O'Connell K, Fritzeen J, Guzzetta CE, Clark AP, Lloyd C, Scott SH, Aldridge M...

Observational mixed-methods study to measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not.

The Spleen Not Taken: Differences in management and outcomes of blunt splenic injuries in teenagers cared for by adult and pediatric trauma teams in a single institution

Visit

O'Connor S, Doud AN, Sieren LM, Miller PR, Zeller KA,

A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents.

Massive transfusion in pediatric trauma: analysis of the National Trauma Databank

Visit

Shroyer MC, Griffin RL, Mortellaro VE, Russell RT,

We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT.

Quality of pediatric abdominal CT scans performed at a dedicated children's hospital and its referring institutions: a multifactorial evaluation

Visit

Snow A, Milliren CE, Graham DA, Callahan MJ, MacDougall RD, Robertson RL, Tay...

Study to identify differences in quality between abdominal CT scans and reports performed at a dedicated children's hospital, and those performed at referring institutions.

Examination of Pediatric Radiation Dose Delivered After Cervical Spine Trauma

Visit

Somppi LK, Frenn KA, Kharbanda AB,

Chart review investigating the utility of x-rays in diagnosing CSIs compared with other forms of imaging.

Identifying Children at Very Low Risk for Blunt Intra-Abdominal Injury in Whom CT of the Abdomen Can Be Avoided Safely

Visit

Streck CJ, Vogel AM, Zhang J, Huang EY, Santore MT, Tsao K, Falcone RA, Dassi...

Prospective study to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary.

Predicting Thoracic Injury in Children With Multitrauma

Visit

Weerdenburg KD, Wales PW, Stephens D, Beno S, Gantz J, Alsop J, Schuh S,

This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI.

Cervical Spine Injuries in Children Associated With Sports and Recreational Activities

Visit

Babcock L, Olsen CS, Jaffe DM, Leonard JC, Cervical Spine Study Group for the...

This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography.

When is it safe to forgo abdominal CT in blunt-injured children?

Visit

Acker SN, Stewart CL, Roosevelt GE, Partrick DA, Moore EE, Bensard DD,

We reviewed all children admitted to 2 pediatric trauma centers after blunt trauma with liver or spleen injury from January 2009 to December 2013.

Use of Oral Contrast for Abdominal Computed Tomography in Children With Blunt Torso Trauma

Visit

Ellison AM, Quayle KS, Bonsu B, Garcia M, Blumberg S, Rogers A, Wootton-Gorge...

This was a planned subanalysis of a prospective, multicenter study of children (<18 years) with blunt torso trauma.

The Use of CT Scan in Hemodynamically Stable Children with Blunt Abdominal Trauma: Look before You Leap

Visit

Nellensteijn DR, Greuter MJ, El Moumni M, Hulscher JB,

We set out to determine the diagnostic value of computed tomographic (CT) scans in relation to the radiation dose, tumor incidence, and tumor mortality by radiation for hemodynamically stable pediatric patients with blunt abdominal injury.

Does Severity of Pelvic Fractures Correlate with the Incidence of Associated Intra-Abdominal Injuries in Children?

Visit

Swaid F, Peleg K, Alfici R, Olsha O, Givon A, Kessel B,

A retrospective cohort study involving blunt trauma patients up to the age of 14 years, who suffered from pelvic fractures, with or without associated intra-abdominal injuries.

Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX)

Visit

Eckert MJ, Wertin TM, Tyner SD, Nelson DW, Izenberg S, Martin MJ,

This is a retrospective review of all pediatric trauma admissions to the North Atlantic Treaty Organization Role 3 hospital, Camp Bastion, Afghanistan, from 2008 to 2012.

Massive transfusion in paediatric and adolescent trauma patients: incidence, patient profile, and outcomes prior to a massive transfusion protocol

Visit

Livingston MH, Singh S, Merritt NH,

We performed a retrospective review of paediatric trauma patients treated at London Heath Sciences Centre between January 1, 2006, and December 31, 2011.

Identifying children at very low risk of clinically important blunt abdominal injuries

Visit

Holmes JF, Lillis K, Monroe D, Borgialli D, Kerrey BT, Mahajan P, Adelgais K,...

We prospectively enrolled children with blunt torso trauma in 20 emergency departments.

Variability of prehospital spinal immobilization in children at risk for cervical spine injury

Visit

Kim EG, Brown KM, Leonard JC, Jaffe DM, Olsen CS, Kuppermann N, C-Spine Study...

We compared prehospital spinal immobilization in 3 age-based cohorts of children with blunt trauma-related CSI transported to 1 of 17 participating hospitals.

The impact of blood product ratios in massively transfused pediatric trauma patients

Visit

Nosanov L, Inaba K, Okoye O, Resnick S, Upperman J, Shulman I, Rhee P, Demetr...

Retrospective analysis assessed patients seen at a level I trauma center between 2003 and 2010 aged 18 years requiring massive packed red blood cell (PRBC) transfusion, defined as transfusion of 50% total blood volume.

Coagulopathy is prevalent and associated with adverse outcomes in transfused pediatric trauma patients

Visit

Hendrickson JE, Shaz BH, Pereira G, Atkins E, Johnson KK, Bao G, Easley KA, J...

A study to evaluate coagulopathy in pediatric trauma patients on presentation to the emergency department, and to quantify the relationship with mortality.

A pediatric massive transfusion protocol

Visit

Chidester SJ, Williams N, Wang W, Groner JI,

Using a prospective cohort, we collected data on all pediatric patients who required un-cross-matched blood from January 1, 2009, through January 1, 2011.

Implementation of a pediatric trauma massive transfusion protocol: one institution's experience

Visit

Hendrickson JE, Shaz BH, Pereira G, Parker PM, Jessup P, Atwell F, Polstra B,...

A study examining whether MTP would improve outcomes in children, through a balanced blood product resuscitation.

Potential adverse effects of spinal immobilization in children

Visit

Leonard JC, Mao J, Jaffe DM

We conducted a prospective cohort study of children presenting to the emergency department (ED) for evaluation following trauma over a 13-month period.

Evaluation for intra-abdominal injury in children after blunt torso trauma: can we reduce unnecessary abdominal computed tomography by utilizing a clinical prediction model?

Visit

Streck CJ Jr, Jewett BM, Wahlquist AH, Gutierrez PS, Russell WS,

A retrospective chart review of all blunt "trauma alerts" for patients younger than 16 years during an 18-month period was performed at a Level I trauma center.

Validation of a prediction rule for the identification of children with intra-abdominal injuries after blunt torso trauma

Visit

Holmes JF, Mao A, Awasthi S, McGahan JP, Wisner DH, Kuppermann N,

We conducted a prospective observational study of children with blunt torso trauma who were evaluated for intra-abdominal injury with abdominal computed tomography (CT), diagnostic laparoscopy, or laparotomy at a Level I trauma center during a 3-year period to validate a previously derived prediction rule.

Outcomes of management in stable children with intra-abdominal free fluid without solid organ injury after blunt abdominal injury

Visit

Venkatesh KR, McQuay N Jr,

The charts of all children less than 18 years of age who had an abdominopelvic CT scan after a blunt abdominal trauma between January 2001 and July 2004 were queried.

The use of routine laboratory studies as screening tools in pediatric abdominal trauma

Visit

Capraro AJ, Mooney D, Waltzman ML,

We undertook a retrospective medical record review of all children with potential major blunt abdominal trauma who entered the Children's Hospital (Boston, MA) trauma registry from July 1996 to August 1999.

Complications of nonoperative management of pediatric blunt hepatic injury: Diagnosis, management, and outcomes

Visit

Giss SR, Dobrilovic N, Brown RL, Garcia VF,

A retrospective study of pediatric patients with blunt hepatic injuries admitted from 1991 through 1997 to a Level I pediatric trauma center was conducted.

Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial

Visit

Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA,

The study was a randomized controlled clinical trial conducted during a 6-month period at 2 Level I trauma centers.

The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience

Visit

Holmes JH 4th, Wiebe DJ, Tataria M, Mattix KD, Mooney DP, Scaife ER, Brown RL...

A retrospective analysis was performed from January 1997 through December 2002 of all pediatric patients (age 0-20 years) with a SOI (liver, spleen, kidney, pancreas) from the trauma registries of seven designated, level I pediatric trauma centers.

Association between the "seat belt sign" and intra-abdominal injury in children with blunt torso trauma

Visit

Sokolove PE, Kuppermann N, Holmes JF,

The authors performed a prospective, observational study of children at risk for IAI who presented to a Level 1 trauma center following a motor vehicle collision (MVC) during a two-year period.

Contrast extravasation predicts the need for operative intervention in children with blunt splenic trauma

Visit

Nwomeh BC, Nadler EP, Meza MP, Bron K, Gaines BA, Ford HR,

A retrospective analysis of 343 patients admitted with blunt splenic injury to our Level I pediatric trauma center over a 7-year period was performed.

Identification of children with intra-abdominal injuries after blunt trauma

Visit

Holmes JF, Sokolove PE, Brant WE, Palchak MJ, Vance CW, Owings JT, Kuppermann N,

The study was a prospective observational series of children younger than 16 years old who sustained blunt trauma and were at risk for intra-abdominal injuries during a 2(1/2)-year period at an urban Level I trauma center.

Prevalence and importance of pneumothoraces visualized on abdominal computed tomographic scan in children with blunt trauma

Visit

Holmes JF, Brant WE, Bogren HG, London KL, Kuppermann N,

We conducted a prospective observational cohort study of children less than 16 years old with blunt trauma undergoing both abdominal CT scan and chest radiography in the emergency department of a Level I trauma center over a 28-month period.

Blunt renal trauma in the pediatric population: indications for radiographic evaluation

Visit

Stein JP, Kaji DM, Eastham J, Freeman JA, Esrig D, Hardy BE,

We retrospectively evaluated the abdominal and pelvic CT scans of 412 children sustaining blunt abdominal trauma between June 1985 and June 1990.

The sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm that minimizes computerized tomography

Visit

Arbuthnot M, Mooney DP,

This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm.

Focused Assessment with Sonography for Trauma (FAST) in Children Following Blunt Abdominal Trauma: A Multi-Institutional Analysis

Visit

Calder BW, Vogel AM, Zhang J, Mauldin PD, Huang EY, Savoie KB, Santore MT, Ts...

A study to investigate the role of FAST for intra-abdominal injury (IAI) and IAI requiring acute intervention (IAI-I) in children after blunt abdominal trauma (BAT).

High ratio plasma resuscitation does not improve survival in pediatric trauma patients

Visit

Cannon JW, Johnson MA, Caskey RC, Borgman MA, Neff LP,

This study sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries.

Consequences of Pediatric Undertriage and Overtriage in a Statewide Trauma System

Visit

Hewes HA, Christensen M, Taillac PP, Mann NC, Jacobsen KK, Fenton SJ,

Study to quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system.

Hypotension and the need for transfusion in pediatric blunt spleen and liver injury: An ATOMAC+ prospective study

Visit

Magoteaux SR, Notrica DM, Langlais CS, Linnaus ME, Raines AR, Letton RW, Alde...

This study sought to determine the relationship between early transfusion in pediatric BLSI and hypotension.

Predictors of Intrathoracic Injury after Blunt Torso Trauma in Children Presenting to an Emergency Department as Trauma Activations

Visit

McNamara C, Mironova I, Lehman E, Olympia RP,

Retrospective chart review to identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature.

Effect of Family Presence on Advanced Trauma Life Support Task Performance During Pediatric Trauma Team Evaluation

Visit

O'Connell KJ, Carter EA, Fritzeen JL, Waterhouse LJ, Burd RS,

We performed a retrospective video review of consecutive pediatric trauma evaluations.

Family Presence During Trauma Resuscitation: Family Members' Attitudes, Behaviors, and Experiences

Visit

O'Connell K, Fritzeen J, Guzzetta CE, Clark AP, Lloyd C, Scott SH, Aldridge M...

Observational mixed-methods study to measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not.

The Spleen Not Taken: Differences in management and outcomes of blunt splenic injuries in teenagers cared for by adult and pediatric trauma teams in a single institution

Visit

O'Connor S, Doud AN, Sieren LM, Miller PR, Zeller KA,

A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents.

Massive transfusion in pediatric trauma: analysis of the National Trauma Databank

Visit

Shroyer MC, Griffin RL, Mortellaro VE, Russell RT,

We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT.

Quality of pediatric abdominal CT scans performed at a dedicated children's hospital and its referring institutions: a multifactorial evaluation

Visit

Snow A, Milliren CE, Graham DA, Callahan MJ, MacDougall RD, Robertson RL, Tay...

Study to identify differences in quality between abdominal CT scans and reports performed at a dedicated children's hospital, and those performed at referring institutions.

Examination of Pediatric Radiation Dose Delivered After Cervical Spine Trauma

Visit

Somppi LK, Frenn KA, Kharbanda AB,

Chart review investigating the utility of x-rays in diagnosing CSIs compared with other forms of imaging.

Identifying Children at Very Low Risk for Blunt Intra-Abdominal Injury in Whom CT of the Abdomen Can Be Avoided Safely

Visit

Streck CJ, Vogel AM, Zhang J, Huang EY, Santore MT, Tsao K, Falcone RA, Dassi...

Prospective study to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary.

Predicting Thoracic Injury in Children With Multitrauma

Visit

Weerdenburg KD, Wales PW, Stephens D, Beno S, Gantz J, Alsop J, Schuh S,

This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI.

Cervical Spine Injuries in Children Associated With Sports and Recreational Activities

Visit

Babcock L, Olsen CS, Jaffe DM, Leonard JC, Cervical Spine Study Group for the...

This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography.

When is it safe to forgo abdominal CT in blunt-injured children?

Visit

Acker SN, Stewart CL, Roosevelt GE, Partrick DA, Moore EE, Bensard DD,

We reviewed all children admitted to 2 pediatric trauma centers after blunt trauma with liver or spleen injury from January 2009 to December 2013.

Use of Oral Contrast for Abdominal Computed Tomography in Children With Blunt Torso Trauma

Visit

Ellison AM, Quayle KS, Bonsu B, Garcia M, Blumberg S, Rogers A, Wootton-Gorge...

This was a planned subanalysis of a prospective, multicenter study of children (<18 years) with blunt torso trauma.

The Use of CT Scan in Hemodynamically Stable Children with Blunt Abdominal Trauma: Look before You Leap

Visit

Nellensteijn DR, Greuter MJ, El Moumni M, Hulscher JB,

We set out to determine the diagnostic value of computed tomographic (CT) scans in relation to the radiation dose, tumor incidence, and tumor mortality by radiation for hemodynamically stable pediatric patients with blunt abdominal injury.

Does Severity of Pelvic Fractures Correlate with the Incidence of Associated Intra-Abdominal Injuries in Children?

Visit

Swaid F, Peleg K, Alfici R, Olsha O, Givon A, Kessel B,

A retrospective cohort study involving blunt trauma patients up to the age of 14 years, who suffered from pelvic fractures, with or without associated intra-abdominal injuries.

Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX)

Visit

Eckert MJ, Wertin TM, Tyner SD, Nelson DW, Izenberg S, Martin MJ,

This is a retrospective review of all pediatric trauma admissions to the North Atlantic Treaty Organization Role 3 hospital, Camp Bastion, Afghanistan, from 2008 to 2012.

Massive transfusion in paediatric and adolescent trauma patients: incidence, patient profile, and outcomes prior to a massive transfusion protocol

Visit

Livingston MH, Singh S, Merritt NH,

We performed a retrospective review of paediatric trauma patients treated at London Heath Sciences Centre between January 1, 2006, and December 31, 2011.

Identifying children at very low risk of clinically important blunt abdominal injuries

Visit

Holmes JF, Lillis K, Monroe D, Borgialli D, Kerrey BT, Mahajan P, Adelgais K,...

We prospectively enrolled children with blunt torso trauma in 20 emergency departments.

Variability of prehospital spinal immobilization in children at risk for cervical spine injury

Visit

Kim EG, Brown KM, Leonard JC, Jaffe DM, Olsen CS, Kuppermann N, C-Spine Study...

We compared prehospital spinal immobilization in 3 age-based cohorts of children with blunt trauma-related CSI transported to 1 of 17 participating hospitals.

The impact of blood product ratios in massively transfused pediatric trauma patients

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Nosanov L, Inaba K, Okoye O, Resnick S, Upperman J, Shulman I, Rhee P, Demetr...

Retrospective analysis assessed patients seen at a level I trauma center between 2003 and 2010 aged 18 years requiring massive packed red blood cell (PRBC) transfusion, defined as transfusion of 50% total blood volume.

Coagulopathy is prevalent and associated with adverse outcomes in transfused pediatric trauma patients

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Hendrickson JE, Shaz BH, Pereira G, Atkins E, Johnson KK, Bao G, Easley KA, J...

A study to evaluate coagulopathy in pediatric trauma patients on presentation to the emergency department, and to quantify the relationship with mortality.

A pediatric massive transfusion protocol

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Chidester SJ, Williams N, Wang W, Groner JI,

Using a prospective cohort, we collected data on all pediatric patients who required un-cross-matched blood from January 1, 2009, through January 1, 2011.

Implementation of a pediatric trauma massive transfusion protocol: one institution's experience

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Hendrickson JE, Shaz BH, Pereira G, Parker PM, Jessup P, Atwell F, Polstra B,...

A study examining whether MTP would improve outcomes in children, through a balanced blood product resuscitation.

Potential adverse effects of spinal immobilization in children

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Leonard JC, Mao J, Jaffe DM

We conducted a prospective cohort study of children presenting to the emergency department (ED) for evaluation following trauma over a 13-month period.

Evaluation for intra-abdominal injury in children after blunt torso trauma: can we reduce unnecessary abdominal computed tomography by utilizing a clinical prediction model?

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Streck CJ Jr, Jewett BM, Wahlquist AH, Gutierrez PS, Russell WS,

A retrospective chart review of all blunt "trauma alerts" for patients younger than 16 years during an 18-month period was performed at a Level I trauma center.

Validation of a prediction rule for the identification of children with intra-abdominal injuries after blunt torso trauma

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Holmes JF, Mao A, Awasthi S, McGahan JP, Wisner DH, Kuppermann N,

We conducted a prospective observational study of children with blunt torso trauma who were evaluated for intra-abdominal injury with abdominal computed tomography (CT), diagnostic laparoscopy, or laparotomy at a Level I trauma center during a 3-year period to validate a previously derived prediction rule.

Outcomes of management in stable children with intra-abdominal free fluid without solid organ injury after blunt abdominal injury

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Venkatesh KR, McQuay N Jr,

The charts of all children less than 18 years of age who had an abdominopelvic CT scan after a blunt abdominal trauma between January 2001 and July 2004 were queried.

The use of routine laboratory studies as screening tools in pediatric abdominal trauma

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Capraro AJ, Mooney D, Waltzman ML,

We undertook a retrospective medical record review of all children with potential major blunt abdominal trauma who entered the Children's Hospital (Boston, MA) trauma registry from July 1996 to August 1999.

Complications of nonoperative management of pediatric blunt hepatic injury: Diagnosis, management, and outcomes

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Giss SR, Dobrilovic N, Brown RL, Garcia VF,

A retrospective study of pediatric patients with blunt hepatic injuries admitted from 1991 through 1997 to a Level I pediatric trauma center was conducted.

Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergency department: the first sonography outcomes assessment program trial

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Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA,

The study was a randomized controlled clinical trial conducted during a 6-month period at 2 Level I trauma centers.

The failure of nonoperative management in pediatric solid organ injury: a multi-institutional experience

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Holmes JH 4th, Wiebe DJ, Tataria M, Mattix KD, Mooney DP, Scaife ER, Brown RL...

A retrospective analysis was performed from January 1997 through December 2002 of all pediatric patients (age 0-20 years) with a SOI (liver, spleen, kidney, pancreas) from the trauma registries of seven designated, level I pediatric trauma centers.

Association between the "seat belt sign" and intra-abdominal injury in children with blunt torso trauma

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Sokolove PE, Kuppermann N, Holmes JF,

The authors performed a prospective, observational study of children at risk for IAI who presented to a Level 1 trauma center following a motor vehicle collision (MVC) during a two-year period.

Contrast extravasation predicts the need for operative intervention in children with blunt splenic trauma

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Nwomeh BC, Nadler EP, Meza MP, Bron K, Gaines BA, Ford HR,

A retrospective analysis of 343 patients admitted with blunt splenic injury to our Level I pediatric trauma center over a 7-year period was performed.

Identification of children with intra-abdominal injuries after blunt trauma

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Holmes JF, Sokolove PE, Brant WE, Palchak MJ, Vance CW, Owings JT, Kuppermann N,

The study was a prospective observational series of children younger than 16 years old who sustained blunt trauma and were at risk for intra-abdominal injuries during a 2(1/2)-year period at an urban Level I trauma center.

Prevalence and importance of pneumothoraces visualized on abdominal computed tomographic scan in children with blunt trauma

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Holmes JF, Brant WE, Bogren HG, London KL, Kuppermann N,

We conducted a prospective observational cohort study of children less than 16 years old with blunt trauma undergoing both abdominal CT scan and chest radiography in the emergency department of a Level I trauma center over a 28-month period.

Blunt renal trauma in the pediatric population: indications for radiographic evaluation

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Stein JP, Kaji DM, Eastham J, Freeman JA, Esrig D, Hardy BE,

We retrospectively evaluated the abdominal and pelvic CT scans of 412 children sustaining blunt abdominal trauma between June 1985 and June 1990.