742 Resource Implications in the Management of Penetrating Trauma in Children

Abstract

Aims: To identify the resource implications in the management of penetrating trauma in children (aged < 16 years of age).

Methods: The paediatric trauma database of all children was used to identify all children with penetrating trauma presenting to our A&E, a major urban trauma centre in London. The study period was over 19 months till December 2009.

Results: During this period, 252 children presented to the Emergency Department following major trauma call activation. 32 of these patients admitted with penetrating trauma. Case-notes were available for 23 patients (71%) The average age was 14.3 years. 91% were male. 2 patients had gun shot wounds. 78% presented between 18:00 and 08:00.

A total of 70 penetrating wounds were documented. The commonest sites were posterior chest (29%), upper limb (20%) & lower limb (17%). 8 had chest drains inserted in the emergency department.

Radiological investigations: CXR (96%), FAST scan (57%) & CT scan (70%). 13 patients (57%) underwent an emergency operation under general anaesthetic: Exploration & wound debridement (6), tendon repair (2), thoractomy (1) & laparotomy (4). Cross specialties involved included PICU (26%), orthopaedics (23%), adult trauma surgeons (13%), plastic surgery (9%), CAHMS / social services (74%). Average length of stay in the PICU was 2.5 days and 3.1 hospital days. There were three deaths of the 32 patients.

Conclusions: Penetrating trauma occurring in the paediatric population is of increasing prevalence. This study highlights the huge resources required to manage such patients.

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