title: Pediatric trauma experience in a combat support hospital in eastern Afghanistan over 10 months, 2010 to 2011.
abstract: We reviewed the pediatric trauma experience of one Combat Support Hospital (CSH) in Afghanistan to focus on injuries, surgery, and outcomes in a war zone. We conducted a review of all pediatric patients over 10 months in an eastern Afghanistan CSH. We studied 41 children (1 to 18 years; mean, 8.5 years; median, 9 years), 28 (68.2%) with penetrating injuries. Blasts (13 patients) and burns (nine) were the most common mechanisms. At arrival 19 (46.3%) underwent endotracheal intubation, four (9.8%) had no palpable blood pressure, 10.6 per cent (four of 38) a Glasgow coma score of 5 or less, 30.6 per cent (11 of 36) base deficits of 6 or less, and 41.7 per cent (15 of 36) hematocrit 30 or less. Red cells were given in 14 (34.1%) and plasma in 11 (26.8%). Of 32 total nonburn patients, 12 (37.5%) had multiple system injuries. Three-fourths of injuries were severe (75.8% [47 of 62] Abbreviated Injury Score 3 or greater). Thirty-two patients (78.0%) required major operations: burn and wound care, orthopedic, chest, abdominal, vascular, and neurosurgical. Second operations were performed in 16 (39.0%), most often burn and orthopedic procedures. Six died (14.6%), 13 were transferred to other hospitals (31.7%), and 20 were discharged to home (48.8%; two not noted). Broad experience in operative trauma care, pediatric resuscitation, and critical care is a priority for military surgeons.
authors: Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia, USA.
authors: Kenneth L
authors: KL
authors: Wilson
authors: Paul J
authors: PJ
authors: Schenarts
authors: Matthew D
authors: MD
authors: Bacchetta
authors: Pradeep R
authors: PR
authors: Rai
authors: Don K
authors: DK
authors: Nakayama
mesh_terms: D000293:Adolescent; D055826:Afghan Campaign 2001-; D000346:Afghanistan / Q000453:epidemiology; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military; D006801:Humans; D015994:Incidence; D008297:Male; D054527:Mass Casualty Incidents / Q000706:statistics & numerical data*; D008887:Military Medicine / Q000379:methods*; D009104:Multiple Trauma / Q000453:epidemiology / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D014950:Wounds, Penetrating / Q000453:epidemiology / Q000601:surgery*