Trauma remains the leading cause of death and
disability for children in the United States. Motor vehicle crashes contribute
to a huge portion of such traumatic injuries in children, and cause over 50 percent of traumatic injury deaths of children. While most research regarding children
in motor vehicle crashes focuses on preventing injuries, my research group
recognizes that prevention is not 100 percent effective. Therefore, we chose to
focus our efforts on the treatment of children injured in motor vehicle crashes
when prevention fails.
One of the most important factors in the
treatment of injured children is the process of trauma triage. Triage is the
process of transporting the “right patient to the right place at the right time.”
The “right place” depends on the severity of the child’s injuries. For severely injured patients, the right
place is usually a specialized trauma center, where doctors specialized in the
treatment of traumatic injuries are on-call 24 hours a day. Failure to identify these children in need of
treatment at a trauma center can result in disability and death. However, it is
not practical to send every child to a trauma center. This would put an undue strain on the trauma
system’s resources and may thus impair care of those more seriously injured
patients.
Currently, most triage systems rely on
assessment of the child after Emergency Medical Technicians (EMTs) have already
arrived on the scene. EMTs assess the child, determine the severity of the
injuries and decide whether or not they need to be transported to a trauma
center. This is problematic for several reasons. First, the assessment and
determination of whether or not a child needs transport to a trauma center may
be highly subjective. Second, it may be impossible to determine, based on the
limited diagnostic tools available in the field, the specific injuries a child
has sustained and thus how severe they actually are. Third, this process may be
long and arduous for children in rural areas who often live long distances from
trauma centers. Such children would require transport by helicopter to the
nearest trauma center. By the time the EMT team arrives on the scene,
determines helicopter transport is necessary and sends for such transport, critical
time is wasted that is best spent treating injuries.
For these reasons, some began to wonder if it
would be possible to determine which children injured in motor vehicle crashes
were likely to need treatment at a trauma center with a systematic approach
even before EMTs arrived at the scene. Such a system could eliminate
some of the bias of the current subjective triage process and could save
precious time for children living in rural areas. This could be accomplished
through an Advanced Automotive Crash Notification (AACN) system. While AACN
systems have been developed for adults, no such systems have been developed
specifically for children.
Our research is focused on creating an AACN system
that will help EMTs decide which children need treatment at a trauma center
after a motor vehicle crash. AACN systems use information
recorded in a vehicle at the time of the crash, such as speed and direction of
impact. They can then use this information to predict the severity of the
injuries occupants in the vehicle are likely to have sustained. This
information can be transported from the vehicle’s black box to EMTs so that the
appropriate resources can be immediately utilized. AACN will not replace the
ability of EMTs to assess and treat children but will improve the ability with
which they can do so quickly and correctly.
We hope that our AACN system can help improve
the care of children injured in motor vehicle crashes throughout the U.S.,
making it possible to get many more of them to the right place at the right
time, no matter where they are injured.
Dr. Andrea Doud, Wake Forest University School of Medicine and CIPT Scholar
-
No comments:
Post a Comment