Limitations of Blood Pressure Measurements in Pediatric Trauma Patients During Field Triage.

Autor:	Frederick A; Trauma, Good Samaritan University Hospital, West Islip, USA., Winslow J; Emergency Medicine, Suffolk County Department of Health Services, Yaphank, USA., Jones V; Pediatric Surgery, Good Samaritan University Hospital, West Islip, USA., Rothburd L; Trauma, Good Samaritan University Hospital, West Islip, USA., Florez B; Nursing, Good Samaritan University Hospital, West Islip, USA., Van Auken E; Trauma, Good Samaritan University Hospital, West Islip, USA., Reens H; Nursing, Molloy University, Rockville, USA., Drucker T; Nursing, Molloy University, Rockville, USA., Melendez Vassall I; Nursing, Molloy University, Rockville, USA., Kaur A; S Jay Levy Fellowship Program, City University of New York, New York City, USA., Mahia A; S Jay Levy Fellowship Program, City University of New York, New York City, USA., Eckardt S; Data Scientist, Eckardt & Eckardt Consulting, St. James, USA., Caronia C; Pediatrics, Good Samaritan University Hospital, West Islip, USA., Eckardt PA; Nursing, Good Samaritan University Hospital, West Islip, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 24; Vol. 16 (9), pp. e70084. Date of Electronic Publication: 2024 Sep 24 (Print Publication: 2024).
DOI:	10.7759/cureus.70084
Abstrakt:	Introduction: Recent revisions of national field triage guidelines recommend the addition of age-specific systolic blood pressure (SBP) measurement for identifying the most severely injured children requiring transport to a trauma center. The purpose of this study was to determine the frequency in which blood pressures are documented by Emergency Medical Service (EMS) providers and the role this measurement has had, among other factors, in triage decisions. Methods: This is an exploratory descriptive study with a retrospective review from the trauma registry database of all pediatric trauma admissions that arrived by EMS at a level II pediatric trauma center from January 1, 2019 to December 31, 2022. Results: Two hundred ninety-eight patient records of patients aged 0 to 14 were included. EMS providers documented blood pressure in 70.1% of the total sample. A significant difference in the frequency of this documentation was seen between ages zero to nine and = > 10 years (χ 2 (1,298) = 28.98 p <0.001). No children ages zero to nine years had SBP of < 70 mmHg + (2x age in years) documented by EMS. There were two children aged = > 10 who had a documented SBP < 90 and 12 children with documented EMS heart rate > SBP. Conclusion: Many children transported by EMS in this hospital's catchment area did have a field blood pressure measurement documented, but the frequency was significantly less in younger-aged children. The blood pressure measurements of children determined to have severe injuries in the sample did not meet the inclusion criteria for high risk of serious injury by the newly established national guidelines. This suggests other prehospital criteria, such as mechanism of injury or visual cues, prompted EMS to transport these pediatric trauma patients to a regional trauma center for specialized care. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of Good Samaritan University Hospital Office issued approval 2023.06.20.07.15. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Frederick et al.)
Databáze:	MEDLINE
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