NCEPOD: Trauma - Who Cares? - London Health Programmes

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CHAPTER 9 - Paediatric careClinical dataAge rangeThere were 68 patients included in the study who were aged16 years of age or less.Most of the data analyses in the previous chapters wererepeated for this small subset of patients. Only in a very fewcases did the analysis show any different patterns from thewhole sample. The bulk of this report is therefore applicableto both adults and children and the analysis will not bepresented again for this group.Figure 47. Age range of patient sample140120Number of patients1008060402000-5 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 91-95Age (years)Figure 48. Overall assessment of care (advisors’ view)Percentage of patients in data set50403020100Good practiceimprovement -clinicalRoom forimprovement -clinicalRoom forimprovement -organisationalRoom forimprovement -clinical andorganisationalLess thansatisfactory>16 years≤16 yearsInsufficient data114
9Paediatric careFigure 49. Grade of first reviewer/team leaderPercentage of patients in dataset6050403020100ConsultantNCCGSpR 3SpR 1/2SpRGrade of clinicianSHONurse>16 years≤16 yearsOtherOverall assessment of careFigure 48 shows overall assessment of care for the paediatricsample compared with the adult sample. There was littledifference between the two groups.Appropriateness of initial responseTable 92 shows advisor assessment of appropriateness ofinitial hospital response.Grade of first reviewer/team leaderFigure 49 shows grade of fi rst reviewer/team leader analysedby age of patient. In comparison with the adult data, it wasencouraging that there was more consultant involvementin the initial management, but still worth noting that aconsultant was the fi rst reviewer in only 54% of cases.<strong>Trauma</strong> team responseA trauma response was documented in the notes in 69% of≤16 year olds, slightly higher than the overall data (58%).Table 92. Appropriateness of initial responsedepending on patient age>16 years ≤16 yearsNumber ofpatientsNumber ofpatients% %Yes 548 86.4 53 88.3No 86 13.6 7 11.7Subtotal 634 60Insuffi cient data 89 8Total 723 68Outcome at 72 hoursSix out of 68 paediatric cases (8.8%) were deceased at 72hours post injury.115
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Trauma: Who cares?A report of the N
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ContentsAcknowledgements 4Foreword
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AcknowledgementsThis is the twenty
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AcknowledgementsThe organisations t
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ForewordSevere injury - a car crash
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Summary of fi ndingsThis study show
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Principal recommendationsOrganisati
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IntroductionTrauma remains the four
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IntroductionReferences1. Chaira 0,
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MethodQuestionnaires and casenotesT
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MethodQuality and confidentialityA
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CHAPTER 1 - Data overviewFigure 2.
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CHAPTER 1 - Data overviewMode of ar
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CHAPTER 2 - Organisational dataTabl
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CHAPTER 3 - Overall assessmentAll c
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CHAPTER 3 - Overall assessmentKey f
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CHAPTER 4 - Prehospital careRespons
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CHAPTER 4 - Prehospital careFigure
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CHAPTER 4 - Prehospital careTranspo
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CHAPTER 4 - Prehospital careAdequac
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CHAPTER 4 - Prehospital careIn 40/5
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CHAPTER 4 - Prehospital carecaused
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CHAPTER 5 - Hospital receptionIntro
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CHAPTER 5 - Hospital receptionTable
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CHAPTER 5 - Hospital receptionTraum
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CHAPTER 5 - Hospital receptionTable
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CHAPTER 5 - Hospital receptionThese
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CHAPTER 5 - Hospital receptionOvera
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CHAPTER 6 - Airway and breathingInt
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Page 114 and 115: CHAPTER 9 - Paediatric careOrganisa
Page 118 and 119: CHAPTER 9 - Paediatric careKey find
Page 120 and 121: CHAPTER 10 - TransfersIntroductionM
Page 122 and 123: CHAPTER 10 - TransfersArrangement o
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Page 126 and 127: CHAPTER 10 - TransfersKey findingsR
Page 128 and 129: CHAPTER 11 -Incidence of trauma and
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Page 136 and 137: APPENDIX B - Injury severity scoreA
Page 138 and 139: APPENDIX C - Adult and paediatric G
Page 140 and 141: APPENDIX D - An example of an excel
Page 142 and 143: APPENDIX E - Level 1 trauma careAs
Page 144 and 145: APPENDIX F - ParticipationTrustCase
Page 150 and 151: APPENDIX G - Corporate structureThe
Page 152: Published November 2007 by the Nati
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