Anu Antony Department of Neurosurgery JPNATC, AIIMS New Delhi
care in Pediatric head injuries –Nursing Neuro surgery ICU
Jul 02, 2015
ABSTRACT
care in Pediatric head injuries –Nursing Neuro surgery ICU
Anu Antony , Deepak Agrawal
Department of Neurosurgery, JPNA Trauma Centre, AIIMS ,New Delhi
Background: Nursing assessment of pediatric head injuries is difficult as GCS scoring system is not applicable to this age group. Also managing head injured children in the same ICU with adults is challenging
Objectives: To assess outcome of admitted pediatric head injury patients (<12yrs) as a surrogate marker for nursing care in the ICU.
Materials &methods: In this prospective study over 9months (Jan2011-Sept2011), the demographic profile ,surgical intervention ,mode of injury and outcome was evaluated for all children with head injury admitted in neurosurgery ICU at JPNA Trauma Center AIIMS.
Result: 104 children with head injury were admitted in the ICU during study period. There were 70males & 34 females. The mean age was 6.5yrs (range day1-12yrs) 51 children had severe head injury, 19 had moderate&34had minor head injury. 51(49%) children underwent surgical intervention. The overall mortality rate was 19.23%(n-20).Mortality rate was 33.3% (n-17) in severe head injuries,5.9% (n-2) in minor head injuries and 5.2%(n-1) in moderate head injury group.84 children were discharged .Of these 84.5%(n-71)had improvement in GCS,10.7%(n-9) had same GCS&4(4.7%) children deteriorated. The average hospital stay was 10 days (range2-94 days).2 patients were still hospitalized at the time of this study.
Conclusion: The mortality rates compare very favorably with international data. This study shows head inured children can be managed appropriately in neurosurgery ICU with nurses trained in neuro- nursing
care in Pediatric head injuries –Nursing Neuro surgery ICU
Anu Antony , Deepak Agrawal
Department of Neurosurgery, JPNA Trauma Centre, AIIMS ,New Delhi
Background: Nursing assessment of pediatric head injuries is difficult as GCS scoring system is not applicable to this age group. Also managing head injured children in the same ICU with adults is challenging
Objectives: To assess outcome of admitted pediatric head injury patients (<12yrs) as a surrogate marker for nursing care in the ICU.
Materials &methods: In this prospective study over 9months (Jan2011-Sept2011), the demographic profile ,surgical intervention ,mode of injury and outcome was evaluated for all children with head injury admitted in neurosurgery ICU at JPNA Trauma Center AIIMS.
Result: 104 children with head injury were admitted in the ICU during study period. There were 70males & 34 females. The mean age was 6.5yrs (range day1-12yrs) 51 children had severe head injury, 19 had moderate&34had minor head injury. 51(49%) children underwent surgical intervention. The overall mortality rate was 19.23%(n-20).Mortality rate was 33.3% (n-17) in severe head injuries,5.9% (n-2) in minor head injuries and 5.2%(n-1) in moderate head injury group.84 children were discharged .Of these 84.5%(n-71)had improvement in GCS,10.7%(n-9) had same GCS&4(4.7%) children deteriorated. The average hospital stay was 10 days (range2-94 days).2 patients were still hospitalized at the time of this study.
Conclusion: The mortality rates compare very favorably with international data. This study shows head inured children can be managed appropriately in neurosurgery ICU with nurses trained in neuro- nursing
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Anu AntonyDepartment of Neurosurgery
JPNATC, AIIMSNew Delhi
Data reported by studies in trauma centers show that head injury represents 75-97% pediatric trauma deaths.
According to National Center for Health Statics the mortality rate from head trauma is 29% in pediatric population.(Pediatric head trauma , Albela stock ,2009)
BACKGROUNDNursing assessment of pediatric head injury cases
are difficult as GCS scoring system is not applicable to thisgroup and also managing head injured children in the same ICU with adults is challenging.Nurse plays a vital role as thereIs no pediatrician in our ICU
OBJECTIVETo assess outcome of admitted
pediatric head injury patients (< 12 years) as a surrogate marker for nursing care in the ICU
MATERIALS AND METHODSType of study – Prospective
Duration – 9 months (Jan 2011 – Sept 2011)
Variable – Age < 12 years
MODE OF INJURY
OTHERS-2
FALL FROM HEIGHT 82
RTA20
OBSERVATIONS
BOYS 70
GIRLS34
OBSERVATIONS No. of patients underwent surgical intervention- 49% (51)
OBSERVATIONDISTRIBUTION OF PATIENTS
DISTRIBUTION OF MORTALITY RATE
17 (33.3%)
OBSERVATION
OBSERVATIONS OVERALL MORTALITY RATE -19.23% (n-20)
OBSERVATION
COMpARISON OF DISCHARGE STATUS
Improved same Deteriorated
29(56.9%) 3(5.9%) 1(2%)
15(78.9%) 2(10.5%) 0
27(84.4%) 2(9.4%) 3(6.25%
OBSERVATIONS Average hospital stay 10 days
(range 2-94 days)
Patients still hospitalized at the
time of this study – 2
CONCLUSIONSThe mortality rates compare vary favorably with
international data.
This study shows that head injured children can
be managed appropriately in neurosurgery ICU
with nurses trained in neuro-nursing
THANK YOU
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