Let the right one in: High admission rate for low-acuity pediatric burns
| Autor: | Stephanie N. Wythe, KuoJen Tsao, Robert F. Martin, Kathryn T. Anderson, Rigoberto Gutierrez, Marisa A. Bartz-Kurycki, Dylan N. Supak, Mary T. Austin, Todd F Huzar, Akemi L. Kawaguchi, Grant M. Garwood |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Patient Transfer medicine.medical_specialty 030230 surgery 03 medical and health sciences Injury Severity Score Patient Admission 0302 clinical medicine Scalding medicine Humans Child Retrospective Studies business.industry Child Protective Services Racial Groups Patient Acuity Infant Admission rate Retrospective cohort study Emergency department medicine.disease Texas Triage Child Preschool 030220 oncology & carcinogenesis Emergency medicine Female Surgery Burns Emergency Service Hospital business Total body surface area |
| Zdroj: | Surgery. 165:360-364 |
| ISSN: | 0039-6060 |
| Popis: | The purpose of this study was to characterize emergency pediatric burn care triage at a tertiary children's hospital to identify targets for quality improvement.A retrospective review of patients18 years with primary burn injuries who presented to a children's emergency department in 2016 was conducted. Demographic and injury characteristics were recorded. Low acuity was defined by size (5% total body surface area burn), depth (not third degree), and no need for conscious sedation for debridement. Multiple logistic regression was used for analysis.A total of 309 pediatric burn patients were triaged in the emergency department. Patients were typically young (median 3.3 years), male (59%), Hispanic (47%), publically insured (77%), and transferred in (65%). Scalding was the most common mechanism (59%). Though most burns were small (median 2% total body surface area), not deep (third degree: 91%), and debrided without sedation (70%), most patients were admitted (80%). On regression, larger total body surface area, child protective services involvement, and in-transfer, but not mechanism, location of injury, or time of day, were associated with observation admission (24 hours) versus emergency department discharge.Though burns were low acuity, most children were admitted. Social factors may play an important role in triage decisions but there may be an opportunity for improved resource utilization. |
| Databáze: | OpenAIRE |
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