THE SYSTEM OF CARE FOR INJURED CHILDREN IN THE STATE OF COLORADO AND THE ROCKY MOUNTAIN REGION OF THE WESTERN UNITED STATES

Cover Page

Abstract


This article describes the different levels of trauma center designation in the United States and focuses on the pediatric trauma centers in the state of Colorado. These urban centers serve a large geographic area that is characterized by rugged mountains, wide open plains and rapidly changing weather patterns. Critical care ground and aeromedical transport are utilized for severely injured children and the quality of care, from initial management in the feld until discharge from the hospital, is critically evaluated by a robust trauma performance improvement (PI) program. The PI program uses audit flters, data analytics and bench-marking to continuously evaluate the network of care to optimize outcomes.


About the authors

Steven L. Moulton

Children’s Hospital Colorado; University Colorado School of Medicine

Author for correspondence.
Email: steven.moulton@childrenscolorado.org

United States

Division of Pediatric Surgery, 13123 East 16th Ave., B-323, Aurora, Colorado,  80045

Department of Surgery, 12631 E. 17th Avenue, C-305, Aurora, Colorado, USA 80045

John F. Recicar Jr

Children’s Hospital Colorado

Email: fake@neicon.ru

United States

Division of Pediatric Surgery,

13123 East 16th Ave., B-323, Aurora, Colorado,  80045

Denis D. Bensard

Children’s Hospital Colorado; University Colorado School of Medicine; Denver Health Medical Center

Email: fake@neicon.ru

United States

Division of Pediatric Surgery, 13123 East 16th Ave., B-323, Aurora, Colorado,  80045

Department of Surgery, 12631 E. 17th Avenue, C-305, Aurora, Colorado, USA 80045

Pediatric Surgery, 777 Bannock St., Denver, CO 80204

References

  1. US Department of Health and Human Services Centers for Disease Control and Prevention. CDC Childhood Injury Report. Protect the ones you love: patterns of unintentional injuries among 0–19 year olds in the United States, 2000–2006; 2008, 1–116. https://www.cdc.gov/safechild/pdf/cdc-childhoodinjury.pdf Accessed October 14, 2018.
  2. Resources for the Optimal Care of Injured Patients, American College of Surgeons, Chicago, IL. https://www.facs.org/~/media/fles/quality%20programs/trauma/vrc%20resources/clarifcation_document.ashx Accessed October 25, 2018.
  3. MacKenzie E.J., Rivara F.P., Jurkovich G.J., Nathens A.B., Frey K.P., Egleston B.L., Salkever D.S., Scharfstein D.O. A national evaluation of the effect of trauma-center care on mortality. NEJM. 2006;354:366–78; PMID: 16436768.
  4. Rutledge R., Fakhry S.M., Meyer A., Sheldon G.F. and Baker C.C. An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury. Ann Surg. 1993;218:512–21 [discussion 521–4]; PMID: 8215642
  5. Farrell L.S., Hannan E..L, Cooper A. Severity of injury and mortality associated with pediatric blunt injuries: hospitals with pediatric intensive care units versus other hospitals. Pediatr. Crit.Care Med. 2004;5:5–9; PMID14697101.
  6. Densmore J.C., Lim H.J., Oldham K.T., Guice K.S. Outcomes and delivery of care in pediatric injury. J. Pediatr. Surg. 2006;41:92–8; PMID: 16410115.
  7. Notrica D.M., Weiss J., Garcia-Filion P., Kuroiwa E., Clarke D., Harte M., Hill J., Moffat S. Pediatric trauma centers: correlation of ACS-verifed trauma centers with CDC statewide pediatric mortality rates. J Trauma Acute Care Surg. 2012;73:566–572; doi: 10.1097/TA.0b013e318265ca6f.
  8. Cirak B., Ziegfeld S., Knight V.M., Chang D., Avellino A.M., Paidas C.M. Spinal injuries in children. J Pediatr. Surg. 2004;39:607–12; PMID: 15065038
  9. Keller M.S., Vane D.W. Management of pediatric blunt splenic injury: comparison of pediatric and adult trauma surgeons. J. Pediatr. Surg. 1995;30:221–4; discussion 224–225; PMID: 7738742
  10. Osler T.M., Vane D.W., Tepas J.J., Rogers F.B., Shackford S.R., Badger G.J. Do pediatric trauma centers have better survival rates than adult trauma centers? An examination of the National Pediatric Trauma Registry. J Trauma. 2001;50:96–101; PMID: 11231677.
  11. Potoka D.A., Schall L.C., Ford H.R. Improved functional outcome for severely injured children treated at pediatric trauma centers. J. Trauma Acute Care Surg. 2001;51:824–34; PMID: 25654233.
  12. United States Government Accountability Ofce. Availability, outcomes, and federal support related to pediatric trauma care. Report to Congressional Requesters. GAO-17–334. March 2017. https://www.gao.gov/assets/690/683706.pdf Accessed October 23, 2018.
  13. Ciesla D.J., Pracht E.E., Leitz P.T., Spain D.A., Staudenmayer K.L., Tepas J.J. The trauma ecosystem: the impact and economics of new trauma centers on a mature statewide trauma system. J Trauma Acute Care Surg. 2017;82:1014–22; PMID: 28328670
  14. Jansen J.O.1, Moore E.E., Wang H., Morrison J.J., Hutchison J.D., Campbell M.K., Sauaia A. Maximizing geographical efciency: An analysis of the confguration of Colorado’s trauma system. J. Trauma Acute Care Surg. 2018;84:762–70; doi: 10.1097/TA.0000000000001802.
  15. Tepas J.J. 3rd, Kerwin A.J., Ra J.h. Unregulated proliferation of trauma centers undermines cost efciency of populationbased injury control. J Trauma Acute Care Surg. 2014;76:576–579; PMID: 24553522.
  16. Brown J.B., Rosengart M.R., Billiar T.R., Peitzman A.B., Sperry J.L. Geographic distribution of trauma centers and injury-related mortality in the United States. J. Trauma Acute Care Surg. 2016;80:42–9; PMID: 26517780.
  17. Kuppermann N., Holmes J.F., Dayan P.S., et al. Identifcation of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009; 374:1160–1170; PMID: 19758692.
  18. Stewart C.L., Acker S.N., Pyle L., Smith D., Bensard D.D., Moulton S.L. Mapping pediatric injuries to target prevention, education, and outreach. J Pediatr Surg 2017;52(8):1287–1291; PMID: 28073490.
  19. Levy, S.J., Kokotailo P.K. Substance use screening, brief intervention, and referral to treatment for pediatricians. Pediatrics. 2011:128(5): e1330–40; PMID: 22042818.
  20. Mitchell S.G., Kelly S.M., Gryczynski J., Myers C.P., O’Grady K.E., Kirk A.S., Schwartz R.P. The CRAFFT cut-points and DSM-5 criteria for alcohol and other drugs: a reevaluation and reexamination. Substance Abuse. 2014;35 (4): 376–80; PMID: 25036144.

Statistics

Views

Abstract - 93

PDF (English) - 0

PDF (Russian) - 0

PlumX

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Dimensions

Refbacks

  • There are currently no refbacks.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies