Assessment of Non-Routine Events and Significant Physiological Disturbances during Emergency Department Evaluation after Pediatric Head Trauma.
brain injuries
errors
medical
pediatrics
protocol compliance
traumatic
vital signs
Journal
Neurotrauma reports
ISSN: 2689-288X
Titre abrégé: Neurotrauma Rep
Pays: United States
ID NLM: 101773091
Informations de publication
Date de publication:
2021
2021
Historique:
entrez:
22
3
2021
pubmed:
23
3
2021
medline:
23
3
2021
Statut:
epublish
Résumé
Outcomes following pediatric traumatic brain injury (TBI) are dependent on initial injury severity and prevention of secondary injury. Hypoxia, hypotension, and hyperventilation following TBI are associated with increased mortality. The purpose of this study was to determine the association of non-routine events (NREs) during the initial resuscitation phase with these physiological disturbances. We conducted a video review of pediatric trauma resuscitations of patients with suspected TBI and Glasgow Coma Scale (GCS) scores <13. NREs were rated as "momentary" if task progression was delayed by <1 min and "moderate" if delayed by >1 min. Vital sign monitor data were used to identify periods of significant physiological disturbances. We calculated the association between the rate of overall and moderate NREs per case and the proportion of cases with abnormal vital signs using multi-variate linear regression, controlling for GCS score and need for intubation. Among 26 resuscitations, 604 NREs were identified with a median of 23 (interquartile range [IQR] 17-27.8, range 5-44) per case. Moderate delay NREs occurred in 19 resuscitations (
Identifiants
pubmed: 33748812
doi: 10.1089/neur.2020.0043
pii: 10.1089/neur.2020.0043
pmc: PMC7962792
doi:
Types de publication
Journal Article
Langues
eng
Pagination
39-47Subventions
Organisme : NLM NIH HHS
ID : R01 LM011834
Pays : United States
Informations de copyright
© Emily C. Alberto et al., 2021; Published by Mary Ann Liebert, Inc.
Déclaration de conflit d'intérêts
No competing financial interest exist.
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