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Attitudes concerning admitting and treating pediatric trauma casualties and mass casualty incidents in general and pediatric emergency departments
Researchers: Bruria Adini1,2, Avishay Goldberg1
- Ben-Gurion University of the Negev
- Tel-Aviv University
Background: Trauma is a major cause of mortality among children. Most pediatric casualties are treated in the general Emergency Departments (EDs), by teams that routinely treat adults. Review of healthcare workers' attitudes is required to examine the appropriateness of pediatric trauma care to the needs.
Objectives: To examine attitudes of policy-makers, managers and general/pediatric ED teams in Israel concerning provision of emergency medicine services to pediatric trauma casualties in routine and in mass casualty incidents; and, the ED perceived as optimal for treating pediatric casualties.
Method: A mixed methods research design was used, integrating qualitative interviews of senior healthcare officials with quantitative questionnaires filled by ED teams.
Findings: Most interviewees, general ED (71%) and pediatric ED (66%) personnel think that the ED teams are proficient in treating pediatric trauma casualties.
The pediatric ED was perceived as preferable for admitting and treating pediatric casualties and the optimal case manager was defined as a pediatric emergency medicine physician.
Training correlated with perceived confidence in treating pediatric casualties, but 44% of the ED staff was not qualified in this field.
80% of ED staff and most interviewees believe that severe pediatric casualties should be referred to designated medical facilities.
The pediatric ED was perceived as preferable for admitting and treating pediatric casualties and the optimal case manager was defined as a pediatric emergency medicine physician.
Training correlated with perceived confidence in treating pediatric casualties, but 44% of the ED staff was not qualified in this field.
80% of ED staff and most interviewees believe that severe pediatric casualties should be referred to designated medical facilities.
Conclusions: Contrary to the current state, pediatric EDs are perceived as the appropriate site for admitting and treating pediatric trauma casualties. Designated training programs are needed to ensure competency of ED teams to treat pediatric casualties.
Recommendations: Review of costs-benefits of operating a designated model for pediatric casualties is recommended including defining the pediatric ED as the admitting and treating site, appointing a specialist in pediatric emergency medicine as case manager and concentrating severe pediatric casualties in designated medical facilities.
Research number: R/189/2015
Research end date: 07/2017