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Children in car crashes fare better at pediatric trauma centers, study says

Children and adolescents had a lower chance of complication or death if treated at a pediatric facility, than if they were treated at a facility for adults.

By
Stephen Feller
Although Level 1 trauma centers are the gold standard for trauma care and equipped for pediatric care, children fare far better at pediatric trauma centers designed and staffed for care of children, rather than those for adults, study suggests. Photo by Odua Images/Shutterstock
Although Level 1 trauma centers are the gold standard for trauma care and equipped for pediatric care, children fare far better at pediatric trauma centers designed and staffed for care of children, rather than those for adults, study suggests. Photo by Odua Images/Shutterstock

ST. PAUL, Minn., May 20 (UPI) -- Because of their greater levels of training and experience treating pediatric conditions, children injured in car crashes fare far better at pediatric trauma centers than at general or adult trauma centers, according to a recent study.

Researchers at Children's Hospitals and Clinics of Minnesota found children were more likely to get proper care for injuries at centers designed to deliver it, and suggest sharing best practices for children among all Level 1 trauma centers to improve pediatric care at non-pediatric centers.

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"Although children treated at level one trauma centers receive the highest level of care, these data suggests adolescents treated at freestanding pediatric hospitals have better outcomes following a motor vehicle accident," Dr. Nathaniel Kreykes, trauma medical director at Children's Hospitals and Clinics of Minnesota, said in a press release. "The conservative approach to pediatric trauma protocols may offer an advantage to injured adolescents as they transition from childhood to adulthood."

For the study, published in the Journal of Pediatric Surgery, researchers reviewed medical data for 28,145 patients under age 18 collected for the National Trauma Data Bank between 2009 and 2012, estimating quality of care for children hurt in a car accident at pediatric and general adult trauma centers.

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Overall, 19.9 percent of children were treated at a pediatric trauma center, 21.4 percent were treated at combination pediatric and general trauma centers and 58.4 percent were treated at general trauma centers. Of injuries to the children, 66.2 percent were for head and neck injuries, while 42.7 percent were for multiple injuries.

Children treated at an adult trauma center had a greater risk for complications such as pneumonia, and adolescents were at a greater risk of death if treated at either an adult or combination center. Children and adolescents at an adult or combination trauma center were also more likely than those at pediatric trauma centers to be treated with invasive injury management that may not be necessary.

"Pediatric trauma centers are exclusively focused on the care of injured children," said Dr. Anupam Kharbanda, chief of critical care services at Children's Hospitals and Clinics of Minnesota. "As such, the care teams are often more comfortable recommending a conservative approach, including observation instead of aggressive treatment or diagnosis, compared to physicians at adult trauma centers who treat fewer pediatric patients. This, combined with very aggressive use of standardized pediatric care pathways in these centers, likely contributes to the better outcomes we noted in this study."

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