title: Do prehospital criteria optimally assign injured children to the appropriate level of trauma team activation and emergency department disposition at a level I pediatric trauma center?
abstract: OBJECTIVE
  To examine the association of prehospital criteria with the appropriate level of trauma team activation (TTA) and emergency department (ED) disposition among injured children at a level I pediatric trauma center.
  
  
  METHODS
  Injured children younger than 15 years and transported by emergency medical services (EMS) from the scene of injury between January 1, 2008 and December 31, 2011 were identified using the institution's trauma registry. Logistic regression was used to study the main outcomes of interest, full TTA (FTTA) and ED disposition.
  
  
  RESULTS
  Out of 3,213 children, 1,991 were eligible and analyzed. Only 279 children initiated the FTTA and 73.9% were admitted. Having a chest injury, abnormal heart rate or Glasgow Coma Scale less than 9 (GCSLT9) in the field was associated with higher odds of initiating the FTTA (odds ratio [OR] = 3.33, 95% confidence interval [CI] 1.54-7.20; OR = 2.59, CI 1.15-5.79 and OR = 2.67, CI 1.14-6.22, respectively). Children with the criteria above in addition to abdominal injury were more likely to be discharged to the ICU, OR or morgue compared to those without them.
  
  
  CONCLUSIONS
  Children with GCSLT9, abnormal heart rate, chest and abdominal injury showed a strong association with FTTA and higher resource utilization.
authors.affiliation: University of Arkansas for Medical Sciences, College of Medicine, Department of Pediatrics, Little Rock, AR, USA, rnabawee@gmail.com.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Nabaweesi
authors.forename: Laura
authors.initials: L
authors.lastname: Morlock
authors.forename: Charles
authors.initials: C
authors.lastname: Lule
authors.forename: Susan
authors.initials: S
authors.lastname: Ziegfeld
authors.forename: Andrea
authors.initials: A
authors.lastname: Gielen
authors.forename: Paul M
authors.initials: PM
authors.lastname: Colombani
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Bowman
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D014218:Triage / Q000379:methods* / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000628:therapy*; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000628:therapy*