Assessment of Non-Routine Events and Significant Physiological Disturbances during Emergency Department Evaluation after Pediatric Head Trauma
| Autor: | Yinan Zheng, Arunachalam A. Thenappan, Aleksandra Sarcevic, Karen J. O'Connell, Ivan Marsic, Chima Oluigbo, Michael J. Amberson, Allison R Harvey, Emily C. Alberto, Randall S. Burd |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
pediatrics Traumatic brain injury business.industry Vital signs General Medicine Emergency department Hypoxia (medical) medicine.disease medical nervous system diseases Head trauma vital signs traumatic nervous system brain injuries protocol compliance Emergency medicine Hyperventilation Protocol Compliance medicine errors Original Article medicine.symptom business |
| Zdroj: | Neurotrauma Reports |
| ISSN: | 2689-288X |
| Popis: | Outcomes following pediatric traumatic brain injury (TBI) are dependent on initial injury severity and prevention of secondary injury. Hypoxia, hypotension, and hyperventilation following TBI are associated with increased mortality. The purpose of this study was to determine the association of non-routine events (NREs) during the initial resuscitation phase with these physiological disturbances. We conducted a video review of pediatric trauma resuscitations of patients with suspected TBI and Glasgow Coma Scale (GCS) scores 1 min. Vital sign monitor data were used to identify periods of significant physiological disturbances. We calculated the association between the rate of overall and moderate NREs per case and the proportion of cases with abnormal vital signs using multi-variate linear regression, controlling for GCS score and need for intubation. Among 26 resuscitations, 604 NREs were identified with a median of 23 (interquartile range [IQR] 17–27.8, range 5–44) per case. Moderate delay NREs occurred in 19 resuscitations (n = 32, median 1 NRE/resuscitation, IQR 0.3–1, range 0–5). Oxygen desaturation and respiratory depression were associated with a greater rate of moderate NREs (p = 0.008, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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