Pediatric Blunt Solid Organ Injury Guidelines: A joint Pediatric Trauma Society (PTS) and Eastern Association for the Surgery of Trauma (EAST) TraumaCast

Committee Chair:

Chair Ian Mitchell MD Email: ian.mitchell@christushealth.org

Co-Chair Mubeen Jafri, MD Email: jafri@ohsu.edu

Solid Organ Injury Guideline
John K. Petty, MD
Brenner Children's Hospital, Winston-Salem, NC

Pancreas Guideline Update
Bindi Naik-Mathuria, MD (PTS)
Texas Children's Hospital, Houston, TX

TEG Based Reversal of Coagulopathy and the TXA Controversy
A. Britton Christmas, MD, FACS (EAST)
Carolinas Medical Center, Charlotte, NC

Blunt Cerebrovascular Injury
Rachael A. Callcut, MD, MSPH, FACS (EAST)
University of California San Francisco, San Francisco, CA

The Guidelines Committee is responsible for developing and disseminating evidence-based information related to pediatric trauma care for the purpose of increasing the scientific knowledge needed to enhance patient care and promote optimal clinical decision-making. Goals of the committee include but are not limited to the following:

• Develops pediatric specific evidence-based guidelines or consensus statement
• Reviews specific evidence-based guidelines for relevance to the pediatric population
• Updates existing evidence-based guidelines based on new clinical information
• Disseminates evidence-based guidelines used by other institutions/organizations

Committee Goals: to develop and disseminate evidence-based information related to pediatric trauma care in order to improve health outcomes.

DEVELOP:
Three working groups

1. Child Abuse/Non-Accidental Trauma Screening Guidelines (LEAD: Tony Escobar)
2. Trauma Transfer Criteria from Community Hospitals to Level One Trauma Centers (LEAD: Matthew Santore)
3. Severe Hemorrhage - Massive Transfusion/Coagulopathy Treatment Guideline (LEAD: Adam Vogel)

DISSEMINATE:
Guidelines in Focus: work to identify guidelines developed by other organizations and share/contextualize for pediatric trauma providers.

Sharing of local clinical pathways/best practices.

Guidelines Committee - Recent Accomplishments

• VTE Guideline
  Published in JTACS 2017
  
  
• Non Accidental Trauma - Renal Trauma
  John Draus (lead), Jonathan Ellison, Judith Hagedorn, Robert Russell, Cordelie Witt, Kristen Zeller
  EAST Collaborator: Nicole Fox
  Submitted to J Trauma for blinded review and presented by Judith Hagedorn at EAST meeting
  View Visual Abstract!
  
  
• Tourniquet Usage in Pediatric Trauma Patients (position statement)
  Mubeen Jafri (lead), Aaron Cunnigham, Mark Cicero, Marc Auerbach
  Future directions: being evaluated by ACS COT for possible endorsement, exploring collaboration with stop the bleed group
  
  
• Non Accidental Trauma (review article)
  Mauricio A. Escobar; Katherine T. Flynn-O'Brien; Marc Auerbach; Gunjan Tiyyagura; Matthew A. Borgman; Susan J. Duffy; Kelly S. Falcone; Rita V. Burke; John M. Cox; Sabine A. Maguire
  
  
• Guidelines in Focus - Concussions
  Byron D. Hughes MD, MPH, Nathaniel Kreykes, MD, Rosemary Nabaweesi, DrPH, Shannon Longshore, MD, Eric Sribnick, MD, John Petty, MD
  (completed- cervical spine, femur fracture, blunt liver/spleen injury)

Guidelines Committee work in progress

• Trauma Transfer: Matt Santore (lead)
  PICO questions formulated, completed literature review  |  Timeline: by 11.2018 review papers and abstraction, present update at PTS meeting
  
  
• Massive Transfusion/Trauma Induced Coagulopathy: Adam Vogel (lead) (EAST collaborators: Bryce Robinson, Chris Dogion)
  PICO questions have formulated, literature search completed  |  Timeline: TBD
  
  
• Skeletal Fractures/Non-accidental Trauma: Ian Mitchell (lead) (Working on collaboration with EAST, Helfer, AAP, ACEP)
  Timeline: TBD