Time to Definitive Care for Severely Injured Pediatric Patients in a Rural State

Details

• Personal Author:
  Peek-Asa, Corinne ; Swanton A ; Young T
• Description:
  Background: Unintentional injury is the leading cause of death among children. Although Iowa has a trauma system designed to provide prompt access to trauma services, little data exists regarding how pediatric patients are processed through this system. We sought to quantify the time to definitive care for severely injured pediatric patients in the state of Iowa and to determine which factors were associated with delays. Methods: Severe pediatric (age <18) injuries presenting to a statewide trauma system were identified and characterized using the Iowa State Trauma Registry from 2005-2013. Time to definitive care was calculated by age and injury type. Finally, a Cox proportional hazard model was developed to identify factors associated with longer time to care. Results: A total of 1,103 severe pediatric injuries were analyzed. Severe injuries most frequently occurred among teens; injuries were also frequent among infants < 1 year of age. Head injuries were most frequent (62%). The median time to definitive care was 1h40min, though this differed for those directly transported (48min) compared to those transferred to the definitive care hospital (3h24min). Being a teenager and using an ambulance were factors associated with shorter time to care, while being an infant and being injured outside an urban area were associated with longer time to care (more delay). Conclusions: Pediatric patients experiencing severe injuries may require substantial time to reach a hospital capable of treating their injuries, particularly among patients undergoing an interfacility transfer. Additionally, infants appear to be at risk for lengthy prehospital times. [Description provided by NIOSH]
• Subjects:
  Adolescent Emergencies Healthcare Disparities Health Care Facilities Workforce And Services Occupational Health Safety
• Keywords:
  Adolescents Author Keywords: Emergency Medical Services Child Health Children Emergency Response Health Care Health Disparities Medical Facilities Medical Records Medical Treatment Teenagers Traumatic Injuries

  More +
• Publisher:
  American Public Health Association
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  Iowa ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20052906
• Citation:
  Health in All Policies, APHA 143rd Annual Meeting and Exposition, October 31-November 4, 2015, Chicago, Illinois. Washington, DC: American Public Health Association, 2015 Nov; :338747
• Federal Fiscal Year:
  2016
• NORA Priority Area:
  Agriculture, Forestry and Fishing
• Performing Organization:
  University of Iowa, Iowa City
• Peer Reviewed:
  False
• Start Date:
  20010930
• Source Full Name:
  Health in All Policies, APHA 143rd Annual Meeting and Exposition, October 31-November 4, 2015, Chicago, Illinois
• End Date:
  20270929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a6fadd7ebd06a5a6def10a2a1cef39c9ae04127cc0e7f67880ee7c2d29248f1e52e605957d513a3ebd8d98a665e1549788c425b226e212ed036c793b8fdbdbfc
• Download URL:
  https://stacks.cdc.gov/view/cdc/215812/cdc_215812_DS1.pdf
• File Type:
  [PDF - 115.80 KB ]