trauma reach workshop - pediatric trauma.pptx [read-only]...pediatric trauma trauma reach workshop...

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PediatricTrauma

TraumaREACHWorkshopMay5th,2015

TamerA.Ahmed,MDPediatricTraumaMedicalDirector

Upstate’sGolisano Children’sHospital

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PediatricTrauma– ABCs

•Airway

•Breathing

•Circulation

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Whatcanwedobetter?

PediatricTrauma

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1997 2009 2014

Pediatric Trauma Systems in North America ‐ 2014

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PediatricTrauma

Whyarekidsdifferent?

PediatricTraumaSystem

NewYorkState

• 21%ofPrehospital traumacare• 5‐10%Prehospital transports• 30%EDvisits• 12%inHospitaltraumacare• 50%ofhospitalsseelessthan10pediatricpatientsperyear

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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

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PediatricTrauma

• 50%ofpediatrictraumadeathsoccurinthefieldbeforethevictimevenreachesatraumacenter

• NationalPediatricTraumaRegistryshowedthatabout70%ofthedeathswerecausedbycentralnervoussystem(CNS)injury

• Areasofimprovement?

Noquickanswers

• Resources

• Geography

“Thetruthis:thebettertheytakecareoftrauma…period…thebettertheywilltakecareofkids.”

‐ ToddMaxson,MD

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AssessmentandReassessment

• ABC’s• Immobilization• Transfer?• Scan?• Operate?

PediatricTrauma– ABCs

•Airway

•Breathing

•Circulation

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PediatricTrauma– ABCs

•Airway

– Inadequateoxygenationandventilation– Twomajorcausesofearlydeath

• Airwaycompromise• Inadequatevolumeresuscitation

PediatricTrauma– ABCs

•Breathing

– Rapidshallowbreaths

– Infantsareobligatenasalbreathers

PediatricTrauma– ABCs

•Breathing

– RespiratoryRate– RespiratoryEffort– Breathsounds– Skincolor,capillaryrefill,pulseoximetry

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PediatricTrauma– ABCs

•Circulation

PediatricTrauma– ABCs

•Circulation

PediatricTrauma– ABCs

•Circulation

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PediatricTrauma– ABCs

•Disability

HowSickisthisKid?

HowSickisthisKid?

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HowSickisthisKid?

Whatdoyouneed?

• EMS

• Localhospital

• PediatricTraumaCenter

CalltoAction

• EstablishmentofRegionalPediatricTraumaTransferProtocols

• Collaboration

• YOURHELP!

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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:ahmedt@upstate.edu

• SteveAdkisson– PediatricTraumaProgramCoordinator

– Office:315‐464‐4773– Cell:315‐396‐1038– Email:adkissos@upstate.edu

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