Invasive Maneuvers and Therapies in the Pediatric Population Affected by Major Trauma: The Experience of a Level 2 Italian Trauma Center

Background: Major trauma poses the need for invasive maneuvers and timely therapies even among pediatric patients

Objective: Assess the need for invasive maneuvers or therapies in the pediatric population affected by major trauma.

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. All patients performed Cts. 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. with regard to invasive maneuvers, 3% required gold tracheal intubation, 4% central venous access, 2% bladder catheterization and 4% positioning a nasogastric tube in ER. as regards ED therapy and invasive maneuvers, 20% required sedation, 20% analgesia, 16% urgent crystalloid infusion, 7% Aìbiotic prophylaxis therapy, 4% tetanus vaccination. 1% required emergency blood transfusion in ED and 10% miscellaneous other therapies. 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 pediatric population studied by us, a significant proportion requires invasive maneuvers and advanced therapy in ED. This once again underlines the need for early, multi-professional and multidisciplinary management of severe pediatric trauma.