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4. Gastric Injury

Author

Hanke, Rachel E., Ziegler, Olivia R., Safford, Shawn D., Kennedy Jr, Alfred P., editor, Ignacio, Romeo C., editor, and Ricca, Robert, editor

Published
2022
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5. Crystalloid Volume is Associated with Short Term Morbidity in Children with Severe Traumatic Brain Injury: An Eastern Association for the Surgery of Trauma Multicenter Trial Post-Hoc Analysis

Author

MacArthur, Taleen A., Vogel, Adam M., Glasgow, Amy E., Moody, Suzanne, Kotagal, Meera, Williams, Regan F., Kayton, Mark L., Alberto, Emily C., Burd, Randall S., Schroeppel, Thomas J., Baerg, Joanne E., Munoz, Amanda, Rothstein, William B., Boomer, Laura A., Campion, Eric M., Robinson, Caitlin, Nygaard, Rachel M., Richardson, Chad J., Garcia, Denise I., Streck, Christian J., Gaffley, Michaela, Petty, John K., Ryan, Mark, Pandya, Samir, Russell, Robert T., Yorkgitis, Brian K., Mull, Jennifer, Pence, Jeffrey, Santore, Matthew T., Klinkner, Denise B., Safford, Shawn D., Trevilian, Tanya, Jensen, Aaron R., Mooney, David P., Ketha, Bavana, Dassinger, Melvin S., III, Goldenberg-Sandau, Anna, Falcone, Richard A., and Polites, Stephanie F.

Published
2023
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7. Prevalence and Outcomes of High versus Low Ratio Plasma to Red Blood Cell Resuscitation in a Multi-Institutional Cohort of Severely Injured Children

Author

Mehl, Steven C., primary, Vogel, Adam M., additional, Glasgow, Amy E., additional, Moody, Suzanne, additional, Kotagal, Meera, additional, Williams, Regan F., additional, Kayton, Mark L., additional, Alberto, Emily C., additional, Burd, Randall S., additional, Schroeppel, Thomas J., additional, Baerg, Joanne E., additional, Munoz, Amanda, additional, Rothstein, William B., additional, Boomer, Laura A., additional, Campion, Eric M., additional, Robinson, Caitlin, additional, Nygaard, Rachel M., additional, Richardson, Chad J., additional, Garcia, Denise I., additional, Streck, Christian J., additional, Gaffley, Michaela, additional, Petty, John K., additional, Greenwell, Cynthia, additional, Pandya, Samir, additional, Waters, Alicia M., additional, Russell, Robert T., additional, Yorkgitis, Brian K., additional, Mull, Jennifer, additional, Pence, Jeffrey, additional, Santore, Matthew T., additional, MacArthur, Taleen A., additional, Klinkner, Denise B., additional, Safford, Shawn D., additional, Trevilian, Tanya, additional, Cunningham, Megan, additional, Black, Christa, additional, Rea, Jessica, additional, Spurrier, Ryan G., additional, Jensen, Aaron R., additional, Farr, Bethany J., additional, Mooney, David P., additional, Ketha, Bavana, additional, Dassinger, Melvin S., additional, Goldenberg-Sandau, Anna, additional, Roman, Janika San, additional, Jenkins, Todd M., additional, Falcone, Richard A., additional, and Polites, Stephanie F., additional

Published
2024
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10. Timing and volume of crystalloid and blood products in pediatric trauma: An Eastern Association for the Surgery of Trauma multicenter prospective observational study

Author

Polites, Stephanie F., Moody, Suzanne, Williams, Regan F., Kayton, Mark L., Alberto, Emily C., Burd, Randall S., Schroeppel, Thomas J., Baerg, Joanne E., Munoz, Amanda, Rothstein, William B., Boomer, Laura A., Campion, Eric M., Robinson, Caitlin, Nygaard, Rachel M., Richardson, Chad J., Garcia, Denise I., Streck, Christian J., Gaffley, Michaela, Petty, John K., Greenwell, Cynthia, Pandya, Samir, Waters, Alicia M., Russell, Robert T., Yorkgitis, Brian K., Mull, Jennifer, Pence, Jeffrey, Santore, Matthew T., MacArthur, Taleen, Klinkner, Denise B., Safford, Shawn D., Trevilian, Tanya, Vogel, Adam M., Cunningham, Megan, Black, Christa, Rea, Jessica, Spurrier, Ryan G., Jensen, Aaron R., Farr, Bethany J., Mooney, David P., Ketha, Bavana, Dassinger, Melvin S., III, Goldenberg-Sandau, Anna, Roman, Janika San, Jenkins, Todd M., and Falcone, Richard A., Jr.

Published
2020
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13. Routine Repeat Imaging of Pediatric Blunt Solid Organ Injuries Is Not Necessary

Author

Fletcher, Kelsey L., Meagher, Mitchell, Spencer, Brianna L., Morgan, Madison E., Safford, Shawn D., Armen, Scott B., Hazelton, Joshua P., and Perea, Lindsey L.

Abstract

Introduction Nonoperative management of hemodynamically stable patients with blunt splenic and/or hepatic injury has been widely accepted in the pediatric population. However, variability exists in the utilization and timing of repeat imaging to assess for delayed complications during index hospitalization. Recent level-IV evidence suggests that repeat imaging in children should be performed based on a patient’s clinical status rather than on a routine basis. The aim of this study is to examine the rate of delayed complications and interventions in pediatric trauma patients with blunt splenic and/or hepatic injuries who undergo repeat imaging prompted either by a clinical change (CC) or non-clinical change (NCC).Methods A 9-year (2011-2019), retrospective, dual-institution study was performed of children (0-17 years) with blunt splenic and/or hepatic injuries. Patients were grouped based on reason for repeat imaging: CC or NCC. The rate of organ-specific delayed complications and interventions was examined by reason for scan.Results A total of 307 injuries were included in the study period (174 splenic, 113 hepatic, and 20 both). Of 194 splenic injuries, 30(15.5%) underwent repeat imaging (CC = 19; NCC = 11). Of 133 hepatic injuries, 27(20.3%) underwent repeat imaging (CC = 21; NCC = 6). There was no difference in the incidence of organ-specific delayed complications between the CC and NCC groups. Of the 4 patients with complications necessitating intervention, only one was identified based on NCC.Conclusions Our data suggest routine repeat imaging is unnecessary in children with blunt splenic and/or hepatic injuries; therefore, practitioners may rely on a patient’s clinical change.

Published
2023
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27. Helmet use among Alaskan children involved in off-road motorized vehicle crashes.

Author

Snyder CW, Muensterer OJ, Sacco F, and Safford SD

Subjects
Accidents, Traffic statistics & numerical data, Adolescent, Age Distribution, Alaska epidemiology, Brain Injuries ethnology, Brain Injuries prevention & control, Child, Child, Preschool, Cohort Studies, Confidence Intervals, Ethnicity, Female, Humans, Incidence, Injury Severity Score, Logistic Models, Male, Odds Ratio, Population Groups ethnology, Registries, Retrospective Studies, Risk Assessment, Rural Population, Sex Distribution, Survival Rate, Trauma Centers, Accidents, Traffic prevention & control, Brain Injuries epidemiology, Head Protective Devices statistics & numerical data, Off-Road Motor Vehicles, Population Groups statistics & numerical data
Abstract

Background: Off-road motorized vehicle crashes are a common source of trauma among Alaska children. Injury morbidity is worse in Alaska Native children than non-Native children, but the reasons are unclear., Objective: To evaluate the differences in helmet use between the Native and the non-Native children, and to assess the impact of helmet use on injury patterns and outcomes., Design: This retrospective cohort study identified patients aged 17 or younger admitted after all-terrain vehicle, snowmobile or motorbike injury between 2001 and 2011 from the Alaska Trauma Registry. Helmeted and non-helmeted patients were compared with respect to demographics, central nervous system (CNS) injury and the overall risk of death or permanent disability. Logistic regression was used to evaluate predictors of helmet use and the effects of ethnicity and helmet use on outcomes., Results: Of the 921 injured children, 51% were Alaska Native and 49% were non-Native. Helmet use was lower among Native versus non-Native patients on unadjusted comparison (24% vs. 71%) and multivariable logistic regression (OR 0.17, 95% CI 0.11-0.27, p<0.0001). Prevalence of CNS injury was higher among Native children (39.7% vs. 30.4%, p=0.016). However, on logistic regression with adjustment for helmet use, Native ethnicity was not a significant predictor of CNS injury (OR 1.07, 95% CI 0.68-1.68, p=0.78), whereas helmet use was strongly protective against CNS injury (OR 0.28, 95% CI 0.18-0.44, p<0.0001) as well as death or permanent disability (OR 0.26, 95% CI 0.10-0.67, p=0.006)., Conclusions: Helmet use is lower among Alaska Native children involved in off-road motorized vehicle crashes. These ethnic disparities in helmet use contribute to higher rates of CNS injury among Native children. Helmet use significantly improves overall outcome. Helmet promotion efforts should be expanded, especially in Native communities.

Published
2014
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