Typing the Injuries Reported Following Major Trauma in the Pediatric Population: The Real-Life of a Level 2 Italian Trauma Center

Background: Major trauma still represents a challenge for emergency doctors and pediatric surgeons today.

Objective: Typing the resulting injuries in the pediatric population that comes to the ER for major trauma in a Italian trauma center 2° level.

Methods: We enrolled patients aged ≤ 14 years who were consecutively referred to our emergency room from 1 January 2014 to 31 December 2018 for major trauma. We then analyzed all the injuries reported following major trauma

Results: We enrolled 99 patients. The average age was 7 years (59% M). 62% for major trauma, 35% for severe head injury, 3% for burns. 55% contracted the trauma on the road, 31% at home and 5% at school. Only 8% arrived self-presented, the remainder accompanied by the territorial emergency. 88% accessed the medical examination with a high priority code and required medium high intensity of care, however, 12% were not recognized at entrance. 100 % have normal vital parameter. The trauma team as well as the emergency doctor was also composed of: in 51% of cases by resuscitator, 50% by neurosurgeon, 37% by pediatric surgeon, 36% by orthopedist and in 5% by otolaryngologist. 36% of patients performed E-FAST. 9% required chest and pelvis x-ray in shock room. All patients performed Cts of which 34% chest CT, 34% abdomen CT, 66% brain CT, 32% limb CT. 50% reported bone lesions, 30% reported skull lesions, 25% to the skin system, 8% to the abdomen, 4% to the spine, 4% to the chest. Only 5% were discharged. 95% were hospitalized either because they needed an observation period or because they needed surgery or intensive care.

Conclusion: in the population we studied, major trauma can damage any part of the body, with a prevalence of bones and skull.