Practice Patterns of Pediatric Surgeons Caring for Stable Patients with Traumatic Solid Organ Injury
- 1 November 1997
- journal article
- research article
- Published by Wolters Kluwer Health
- Vol. 43 (5), 820-824
- https://doi.org/10.1097/00005373-199711000-00014
Abstract
Managed care financing has resulted in pressure to decrease hospital days and lower per diem costs. This influence may ultimately affect nonoperative management of blunt solid organ injuries in children (spleen, liver, kidneys). Pediatric surgeons caring for trauma patients were surveyed regarding current practice patterns. One survey was sent to a representative staff pediatric surgeon at each major children's hospital or children's unit involved in the care of the injured child in the United States. There were 87 responses to 117 surveys (75%). Relatively few children fail nonoperative management. For major management decisions, including radiographic study of choice; when to transfuse; and when to allow out of bed, home, and back to school, there was often a clear majority opinion of appropriate care. However, there was a wide variance in response for some questions. Surgical judgment must be individualized, but a low number of failures of nonoperative management is helpful in delineating safe practice guidelines. Surgeons using fewer resources than the norm may help delineate management schemes that are equally effective to more expensive care. Based on these responses a management protocol is recommended.Keywords
This publication has 20 references indexed in Scilit:
- Prospective Study Investigating Routine Usage of Ultrasonography as the Initial Diagnostic Modality for the Evaluation of Children Sustaining Blunt Abdominal TraumaPublished by Wolters Kluwer Health ,1997
- Nonoperative Management of Blunt Hepatic and Splenic Injury in ChildrenAnnals of Surgery, 1996
- Splenic injury in children after blunt trauma: Blood transfusion requirements and length of hospitalization for laparotomy versus observationJournal of Pediatric Surgery, 1994
- Selective nonoperative management of pediatric blunt splenic trauma: Risk for missed associated injuriesJournal of Pediatric Surgery, 1994
- Is early discharge following isolated splenic injury in the hemodynamically stable child possible?Journal of Pediatric Surgery, 1993
- Commentary: Emergency department sonography in the initial evaluation of blunt abdominal injury in childrenPediatric Radiology, 1993
- BLUNT ABDOMINAL TRAUMA IN CHILDREN: THE PRACTICAL VALUE OF ULTRASONOGRAPHYPublished by Wolters Kluwer Health ,1993
- Major Blunt Renal Trauma in the Pediatric Population: Is a Nonoperative Approach Indicated?Journal of Urology, 1993
- The place of ultrasonographic examination in the initial evaluation of children sustaning blunt abdominal traumaJournal of Pediatric Surgery, 1993
- Transfusion requirements in conservative nonoperative management of blunt splenic and hepatic injuries during childhoodJournal of Pediatric Surgery, 1990