Mild Head Trauma in the Pediatric Population under the Age of 2: Real-Life Process and Performance Times Analysis of a Level 2 Trauma Center

Background: Head injuries represent one of the most important causes of morbidity and mortality in pediatric age. Exposure to the ED environment must be minimized given the young age of the patients.

Objective: Evaluate in the pediatric population under 2 years of age if the adherence to the entire protocol derived from the Pediatric Emergency Care Applied Research Network keeps the time spent by patients in the emergency room limited.

Methods: Aged ≤ 2 years who are consecutively referred to our emergency room from January 1st to December 31st 2018.

Results: We enrolled 250 patients under 2 years of age. 88.4% came from domestic accidents, 1.2% from road accidents, and the remainder from other causes. 98.4% accessed the medical examination with a low priority code and required low intensity of care, 1.6% required high priority to the medical examination and the overall 0.4% required medium or high intensity of care. 95.2% were discharged and only 2.4% were hospitalized for observation in pediatrics. The remaining 2.4% preferred home observation despite medical recommendations. Only 0.8% of patients had a high (yellow or red) severity code at discharge. The average waiting times for the medical examination were 30 minutes with a median of 22 minutes. The overall hospital stay in the emergency room was on average 118 minutes with a median of 105 minutes. 2.8% of patients had a re-visit within the next day and a complex of 3.6% within 5 days. None of the patients had complications due to the fall at follow-up.

Conclusion: The application of this protocol in the pediatric population under the age of 2 has resulted in a reduced stay in the emergency room of these patients.