Citation

Bonasso PC, Gurien LA, Smith SD, Saylors ME, Dassinger MS. J. Trauma Acute Care Surg. 2018; 84(5): 758-761.

Affiliation

University of Arkansas for Medical Sciences. Division of Pediatric Surgery.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001799

PMID

29334567

Abstract

BACKGROUND: Variation exists in pediatric vascular trauma management. We aim to determine practice patterns for vascular trauma management at American College of Surgeons (ACS) verified pediatric trauma centers and evaluate the resources available for management of vascular trauma at both freestanding children's hospitals (FSCH) and pediatric hospitals within general adult hospitals (PHGAH).

METHODS: Pediatric surgeons and trauma medical directors at ACS designated pediatric surgery trauma centers completed a survey designed to evaluate anticipated management of traumatic arterial injuries and resource availability. Hospital setting comparisons were made using Fisher's exact tests and t-tests. Binomial tests were used to compare pediatric and vascular surgeons' responses to clinical vignettes. P-values ≤0.05 were significant.

RESULTS: 176 of 414 (42%) pediatric surgeons participated. Vascular surgeons are more likely to operatively manage vascular trauma at all anatomic sites except subclavian artery when compared to pediatric surgeons, regardless of hospital setting (p <0.001). 48% of the pediatric trauma medical directors completed their portion of the survey. At FSCHs, 36% did not have a fellowship trained vascular surgeon on call schedule, 27% did not have endovascular capabilities, and 18% did not have a radiology technologist always available.

CONCLUSIONS: Vascular surgeons are more likely to manage pediatric vascular trauma regardless of hospital setting. However, FSCH have fewer resources available to provide optimal care. LEVEL OF EVIDENCE: IV, Survey.

Language: en