title: Drug use and screening in pediatric trauma.
abstract: BACKGROUND
  There is a paucity of research on substance use in the pediatric trauma population. This study aims to describe trends in substance use and screening in the Canadian pediatric trauma population.
  
  
  METHODS
  A retrospective review of the London Health Sciences Centre trauma database from April 1999 to January 2009 identified patients less than 18 years old admitted after major trauma [injury severity score (ISS) > 12]. Data extracted included age, gender, ISS, blood alcohol concentration (BAC), and results of toxicology screens.
  
  
  RESULTS
  BAC data were available for 799 patients and toxicology screens for 761 patients. BAC testing was completed in 30% (21% positive). Toxicology screens were completed in 7% (44% positive). Increasing age was associated with screening for alcohol (odds ratio = 1.4; 95% confidence interval 1.3-1.5). Screening for drug use had a bimodal distribution, with no children aged 4-10 years screened. Those screened for drugs and alcohol had a significantly higher ISS than those not tested (BAC 28 versus 23, P < 0.001, toxin screening 29 versus 24, P = 0.003). The most common ingestions were alcohol, benzodiazepines, cannabinoids, and opiates.
  
  
  CONCLUSIONS
  Screening for drugs and alcohol is sporadic in the pediatric trauma population. Further study utilizing a universal approach to drug and alcohol screening is needed to further delineate the true prevalence of substance use in this population.
authors: Division of General Surgery, Department of Surgery, London Health Sciences Center, London, Ontario, Canada. kmartin2008@meds.uwo.ca
authors: Kathryn L
authors: KL
authors: Martin
authors: Kelly N
authors: KN
authors: Vogt
authors: Murray J
authors: MJ
authors: Girotti
authors: Tanya C
authors: TC
authors: Stewart
authors: Neil G
authors: NG
authors: Parry
mesh_terms: D000293:Adolescent; D000438:Alcohols / Q000097:blood; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D012307:Risk Factors; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000097:blood / Q000453:epidemiology*
chemical_list: D000438:Alcohols