by Elana Gotkine

Pediatric patients self-presenting with injuries consistent with major trauma typically have external signs of injury, notably boggy swelling to the head, abdominal bruising, and thigh swelling, according to a study presented at the European Emergency Medicine Congress, held from Oct. 13 to 16 in Copenhagen, Denmark.

Robert Hirst, from Bristol Royal Infirmary in the United Kingdom, and colleagues reported outcomes for pediatric patients presenting with injuries consistent with major trauma between Aug. 5, 2020, and May 6, 2022.

Through the study period, 153 major trauma patients presented to the emergency department, with 24 self-presenting who were eligible for inclusion. The researchers found that the mean patient age was 6.22 years, and 75 percent were male. The mean time to be seen was 58.5 minutes; none of the patients received trauma team activation.

The mechanism of injury was mainly falls, sporting injuries, bicycle injuries, and being dropped (50, 25, 8.3, and 4.2 percent, respectively); 12.5 percent of injuries (three patients) were unexplained. Most injuries (95.8 percent) involved a single body region, mainly head injuries (54.2 percent); 33.3 and 12.5 percent were extremity injuries and intra-abdominal injuries, respectively.

The median Abbreviated Injury Scale was 3, and median Injury Severity Score was 9. Six children scored >15, classified as major trauma. Most of the patients (91.6 percent) had obvious external signs of injury, notably boggy swelling to head, abdominal bruising, or thigh swelling/deformity; most had relatively unremarkable clinical observations.

"Adoption of simple triage alerts for the three key features identified to prompt immediate senior clinician review might improve management of this group by triggering appropriate trauma team allocation and appropriate allocation of resources for this high-risk population," the authors write.

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