Pediatric Trauma Society

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Take Me to Peds: Growing Pains and Process Changes in Pediatric Trauma Care
Megan Waddell, BSN, RN, CPEN1; Crystal Bencken, MSN, RN, CEN, CPEN, CHSE2; Chad Scarboro, MD, MD2; Britt Christmas, MD2; John Ehlers, BA2
1Atrium Health/Carolinas Healthcare, Mooresboro, NC; 2Atrium Health, Charlotte, NC

Background: Prior to 2018, the highest-level pediatric trauma activations were dispositioned to the Adult Emergency Department (ED). During recent trauma center accreditation, the American College of Surgeons (ACS) recommended that these patients be dispositioned to the Pediatric ED (PED) with staff specializing in pediatric care. We undertook this project to evaluate and improve the performance of the PED trauma response team in preparation for this transition.

Methods: Multiple pediatric trauma simulations were conducted over a 4-month period in the PED to evaluate the on-duty response team. A skills checklist which identified safety gaps was completed by content expert observers during each simulation. An anonymous electronic survey was also administered to assess confidence levels in caring for pediatric trauma. Data was utilized to evaluate the readiness of the PED, develop action plans, and implement process improvements.

Results: Several equipment deficiencies were identified (blood refrigerator, pediatric thoracotomy tray, fluid warmers) and remedied. We received 90 participant surveys reporting teammate confidence on a 5-point Likert Scale, 1 being "Minimally Confident" and 5 being "Highly Confident." Confidence levels improved across intervals (3.38 to 3.76). We continued simulations for an additional two months for education purposes and found that confidence continued to improve (3.84).

Conclusion: Pediatric trauma simulations successfully identified deficiencies and improved teammate confidence in preparation for transition of pediatric trauma codes to the PED. We will continue to conduct pediatric trauma simulations to improve knowledge, confidence, and performance in the management of pediatric trauma patients.

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