Time to Definitive Care for Severely Injured Pediatric Patients in a Rural State
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.
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.
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).
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.
Learning Areas:Provision of health care to the public
Describe time to definitive care for severely injured pediatric patients in the state of Iowa. List which factors are associated with longer time to care.
Keyword(s): Emergency Medical Services, Child Health
Qualified on the content I am responsible for because: I have previously published worked based on data from the Iowa State Trauma Registry and, through my thesis work, have appled methods to identify prehospital delays for specific populations.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.