title: Effectiveness of a pediatric trauma team protocol.
abstract: OBJECTIVE
  To determine the effectiveness of a pediatric trauma triage system and resource allocation for emergency medicine and trauma services. TRAUMA SYSTEM: Two-tier trauma team activation system that triages patients into Level 1 and Level 2 trauma alert categories based on information provided by pre-hospital providers to pediatric emergency physicians at an American College of Surgeons' Level 1 pediatric trauma center in Columbus, Ohio.
  
  
  METHODS
  Using the hospital trauma registry database and patient medical records, a retrospective chart review was conducted on all (n = 542) admitted pediatric trauma patients from January 1995 through December 1996.
  
  
  RESULTS
  Level 1 patients had a higher median injury severity score and shorter emergency department (ED) length of stay time than Level 2 patients. Level 1 patients were more likely to be admitted to the pediatric intensive care unit and remain for more than 24 hours when compared to Level 2 patients. In addition, Level 1 patients were more likely to have procedures performed (eg, intubation, tube thoracostomy, thoracotomy, diagnostic peritoneal lavage) than Level 2 patients. The mortality rate was significantly higher for Level 1 patients and all ED deaths had been triaged to the Level 1 category.
  
  
  CONCLUSIONS
  This pediatric trauma triage system effectively predicts which patients will be more likely to have serious injury. By using a two-tier system, select patients may be managed by a smaller trauma team, thus improving staff utilization and possibly reducing costs while ensuring favorable outcomes.
authors.affiliation: The Ohio State University College of Medicine and Public Health, Department of Pediatrics, Children's Hospital, Columbus 43205, USA. nussk@pediatrics.ohio-state.edu
authors.forename: K E
authors.initials: KE
authors.lastname: Nuss
authors.forename: A M
authors.initials: AM
authors.lastname: Dietrich
authors.forename: G A
authors.initials: GA
authors.lastname: Smith
mesh_terms: D002648:Child; D002985:Clinical Protocols / Q000592:standards*; D003422:Critical Care / Q000592:standards; D004635:Emergency Medicine / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D009820:Ohio; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D010372:Pediatrics / Q000458:organization & administration / Q000592:standards*; D012189:Retrospective Studies; D014193:Trauma Centers / Q000592:standards*; D015599:Trauma Severity Indices; D014218:Triage / Q000458:organization & administration / Q000592:standards*; D014947:Wounds and Injuries / Q000145:classification* / Q000401:mortality / Q000628:therapy*