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Florida Public Health Review

Publication Date

5-5-2020

Abstract

Background: The current trauma system in Collier County disperses injured pediatric patients to trauma centers outside the County. There is a critical gap in knowledge in the epidemiology of the County’s pediatric trauma patients.

Purpose: To understand injury patterns in children ages 0-17 years in Collier County and identify challenges in transporting injured children to definitive care.

Methods: This is a cross sectional, descriptive study using a sequential mixed-methods design. A thorough review of the literature and interviews of key stakeholders were conducted in August 2017. Data obtained from the interviews was used to develop a causal loop diagram using Vensim modeling (version 7.2). De-identified hospital and EMS database from January 1, 2012 to April 20, 2018 was analyzed. Descriptive statistics were calculated for age, gender, ethnicity, race, reason for transport, refusal of care, mechanism of injury, disposition and zone of injury variables. Statistical analyses were conducted using SPSS version 25 and R 3.3.1.2. Statistical significance was set at alpha <0.05.

Results: 5,297 records were evaluated. 95% of the pediatric EMS calls were trauma related. 90% of injured children received care at the County’s acute care hospitals. 7/10,000 children per year were trauma alerts transported out of the County. Bad weather was the main factor impeding transport outside the County. No data is available on outcomes of trauma alert patients who received care outside the County.

Discussion: Our County lacks data on trauma services and outcomes for pediatric patients, despite population growth. Severe weather impedes the transfer to TCs, keeping these patients at the local hospitals. There is insufficient evidence to demonstrate that the current management of injured children in the County provides the best outcomes. This study concludes with a series of recommendations to develop a local trauma database, integrate services and mature into a robust and organized system.

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