One-year experience in a regional pediatric trauma center

Paul M. Colombani, James R. Buck, David L. Dudgeon, David Miller, J. Alex Haller

Research output: Contribution to journalArticle

Abstract

During 1982, 267 children with life-threatening injuries were admitted to the Maryland Regional Pediatric Trauma Center at the Johns Hopkins Hospital. Seventy-three percent of patients arrived directly from the injury scene by helicopter (46%), ambulance (50%), or other (4%). Mechanisms of injury included motor vehicle accidents (MVA;55%), falls (27%), assaults (8%), and sports and other injuries (10%). In 75% of MVA the child was a pedestrian. Fifty-one percent of injuries were single organ system, 29% involved two systems, and 20% involved three or more systems. Remarkably, the mortality of 6.7% was not affected by the number of organ systems involved, but was directly related to the presence or absence of head injury. Fourteen of seventeen deaths resulted from head injury. Eighty percent of documented liver and spleen injuries were managed nonoperatively. This nonoperative plan of management simplified the optimal treatment of head injury. The high frequency of head injury has mandated a more aggressive approach to the management of brain trauma including intracranial monitoring to facilitate control of cerebral edema. Our data demonstrate that an excellent quality of life may be anticipated even in children with severe head injury.

Original languageEnglish (US)
Pages (from-to)8-13
Number of pages6
JournalJournal of pediatric surgery
Volume20
Issue number1
DOIs
StatePublished - Feb 1985

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Keywords

  • Pediatric trauma
  • helicopter transport

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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