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Pediatric Trauma Readiness: A Trauma-Specific Assessment to Complement the National Pediatric Readiness Project
Hale E. Wills, MD, MS1; Timothy Genovese, BS2; Carolina Roberts-Santana, MD, MHA3
1Hasbro Children's Hospital/Alpert Medical School of Brown Univesity, Providence, RI; 2Alpert Medical School at Brown University, Providence, RI; 3Rhode Island Department of Health, Providence, RI

Background: The EMS-C National Pediatric Readiness Project (PedsReady) surveyed US ED's in 2013 for pediatric readiness but did not query for elements essential to ATLS. We sought to create a pediatric trauma-specific survey to compliment the 2017 PedsReady survey to address this gap.

Methods: Our ACS Level 1 PTC and state Department of Health developed a survey reflecting ATLS principles regarding pediatric-specific trauma stabilization, clinical/administrative resources, and inter-facility transfer. We distributed to all ED medical directors in our state in 2017.

Results: All eleven facilities responded. Nine lacked physician or nurse pediatric trauma coordinators. Nine had thresholds of comfort with stabilization of children that varied by age and procedure (e.g. airway, IV access). The two comfortable with all aspects of stabilizing all ages also were the only two with 24-7 access to all pediatric trauma specialists. Nine facilities had limited or no access to neurosurgery. Pediatric protocols varied: hyperosmolar therapy (1), neurological assessment (3), chest injury (4), massive transfusion (1), triage (5), trauma transfer agreements (10), imaging-limitation protocols (4), internal (1) and inter-facility (4) QA/QI process (1), and real-time image transfer (11).

Conclusions: Our pediatric trauma-specific assessment complimented the PedsReady survey and identified gaps in our one-state pilot. We identified gaps in pediatric trauma readiness, the most concerning of which were facilities which lacked comfort and the resources to stabilize injured children with no specialist backup. We anticipate using our findings in our state for resource development. Our survey could serve as a model for national pediatric trauma-specific readiness assessment.


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