trauma reach workshop - pediatric trauma.pptx [read-only]...pediatric trauma trauma reach workshop...
TRANSCRIPT
5/4/2015
1
PediatricTrauma
TraumaREACHWorkshopMay5th,2015
TamerA.Ahmed,MDPediatricTraumaMedicalDirector
Upstate’sGolisano Children’sHospital
5/4/2015
2
5/4/2015
3
PediatricTrauma– ABCs
•Airway
•Breathing
•Circulation
5/4/2015
4
Whatcanwedobetter?
PediatricTrauma
34
65
79
0
20
40
60
80
100
1997 2009 2014
Pediatric Trauma Systems in North America ‐ 2014
5/4/2015
5
PediatricTrauma
Whyarekidsdifferent?
PediatricTraumaSystem
NewYorkState
• 21%ofPrehospital traumacare• 5‐10%Prehospital transports• 30%EDvisits• 12%inHospitaltraumacare• 50%ofhospitalsseelessthan10pediatricpatientsperyear
5/4/2015
6
PediatricTraumaCenter
• Mortality– Improvedmortality– Improvedoutcome
• TraumaticBrainInjury– LowermortalityratesinPTCcomparedtoATC
• Solidorganinjuries– IncidenceofoperativeinterventionlowerinPTC
• DecreasedMortalityinmultisysteminjuredpatients
PediatricTraumaCenter‐ Resources
• PediatricTraumaService
• PediatricEmergencyPhysician
• PediatricCriticalCarePhysician&PICU
• PediatricSpecialists– ENT– Orthopedics– Neurosurgery
• PediatricRadiology• PediatricNursing• PediatricTraumasystem
• ChildLifeandFamilySupportSystems
• PediatricSocialWork• Pediatricinjurypreventionandeducation
PediatricTraumaSystem
• AvailabilityofResources
• Communication
• Feedback
• PediatricSpecific
5/4/2015
7
PediatricTrauma
• 50%ofpediatrictraumadeathsoccurinthefieldbeforethevictimevenreachesatraumacenter
• NationalPediatricTraumaRegistryshowedthatabout70%ofthedeathswerecausedbycentralnervoussystem(CNS)injury
• Areasofimprovement?
Noquickanswers
• Resources
• Geography
“Thetruthis:thebettertheytakecareoftrauma…period…thebettertheywilltakecareofkids.”
‐ ToddMaxson,MD
5/4/2015
8
AssessmentandReassessment
• ABC’s• Immobilization• Transfer?• Scan?• Operate?
PediatricTrauma– ABCs
•Airway
•Breathing
•Circulation
5/4/2015
9
PediatricTrauma– ABCs
•Airway
– Inadequateoxygenationandventilation– Twomajorcausesofearlydeath
• Airwaycompromise• Inadequatevolumeresuscitation
PediatricTrauma– ABCs
•Breathing
– Rapidshallowbreaths
– Infantsareobligatenasalbreathers
PediatricTrauma– ABCs
•Breathing
– RespiratoryRate– RespiratoryEffort– Breathsounds– Skincolor,capillaryrefill,pulseoximetry
5/4/2015
10
PediatricTrauma– ABCs
•Circulation
PediatricTrauma– ABCs
•Circulation
PediatricTrauma– ABCs
•Circulation
5/4/2015
11
PediatricTrauma– ABCs
•Disability
HowSickisthisKid?
HowSickisthisKid?
5/4/2015
12
HowSickisthisKid?
Whatdoyouneed?
• EMS
• Localhospital
• PediatricTraumaCenter
CalltoAction
• EstablishmentofRegionalPediatricTraumaTransferProtocols
• Collaboration
• YOURHELP!
5/4/2015
13
PediatricTraumaCenter
• Pediatric Subspecialties
• Education
• Rehab services
• Education/outreach
• Public Health
• Treatment
• Stabilization/Transfer
• Communication of needs
• EMS
• Prevention programs
• Education
Pre‐hospital
Area Hospital
GCHPost Trauma
Resources
PediatricTrauma
• TamerAhmed– PediatricTraumaMedicalDirector
– Office:315‐464‐2878– Cell:315‐200‐7538– Email:[email protected]
• SteveAdkisson– PediatricTraumaProgramCoordinator
– Office:315‐464‐4773– Cell:315‐396‐1038– Email:[email protected]
5/4/2015
14