Dr Warwick Teague Director of Trauma Services Consultant Paediatric & Burns Surgeon
Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre
Feb 11, 2017
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DrWarwickTeagueDirectorofTraumaServicesConsultantPaediatric&BurnsSurgeon
Matterofdoordie?1
Evidence?Keyreferenceswillbeprovided.ShowmeyoursandI’llshowyoumine!
• Survivalinpaediatricvsadulttraumacentres?CompellingdatainfavourConfusingqualificationsGofigure…
• Survivalinpaediatricvsadulttraumacentres?CompellingdatainfavourConfusingqualificationsGofigure…
Survivalisbetter (orasgood)inapaediatriccentre,…BUT
Conclusion?
Matterofdoordie?1
Evidence?Keyreferenceswillbeprovided.ShowmeyoursandI’llshowyoumine!
• ChildrenwhosurviveseveretraumaneedhighestqualitycareIatrogenicmorbidityapplyingadultservicestopaediatricpatientsExamplesincludeCTradiation,splenectomy
Matterorlifeordeath2
Relax,…IfIgaveyouallthereferenceshereyoumightnotcometothedebate!
• ChildrenwhosurviveseveretraumaneedhighestqualitycareIatrogenicmorbidityapplyingadultservicestopaediatricpatientsExamplesincludeCTradiation,splenectomy
.
Childspecificcareisunique topaediatriccentres,…AND
Conclusion
Matterorlifeordeath2
Relax,…IfIgaveyouallthereferenceshereyoumightnotcometothedebate!
• Qualityofcareisnotjustaboutclinicalcapacityorcompetence,…QualityofexperienceKid-centeredenvironment
Matteroflaughinlife3
Itwouldn’t beapaediatrictalkwithout afewcartoongraphics.
“ClownDoctorsnowtouchthelivesofover 100,000peopleeveryyear. Wearenowpartofhospitallifeinall majorchildren'shospitalsaroundAustralia.”
www.humourfoundation.com.au
• Qualityofcareisnotjustaboutclinicalcapacityorcompetence,…QualityofexperienceKid-centeredenvironment
.
Injuredchildrenneedmore thangood doctors,…AND
Matteroflaughinlife3
Conclusion?
Itwouldn’t beapaediatrictalkwithout afewcartoongraphics.
• Whoislookingaftertheparentsandsiblingsinyouradulttraumacentre?FamilysupportworkerRealneeds,realdeficits
Toosentimental?Buildabridge.
Cryandyoucryalone?4
• Whoislookingaftertheparentsandsiblingsinyouradulttraumacentre?FamilysupportworkerRealneeds,realdeficits
Conclusion?
Toosentimental?Buildabridge.
Aseverelyinjuredchildhasatraumatised family tocarefor.
Cryandyoucryalone?4
• WherewouldItakemyownseverelyinjuredchild?NobrainerNoexceptions?!?ExceptionsareOK
Youcanfindsflawsinmostarguments,butasoftenasnot,you’vemissedthepoint,…itisaCHILD!
Theultimatetest5
• WherewouldItakemyownseverelyinjuredchild?NobrainerNoexceptions?!?ExceptionsareOK
.Conclusion?
Youcanfindsflawsinmostarguments,butasoftenasnot,you’vemissedthepoint,…itisaCHILD!
Paediatrictraumacentersarethebest placeforinjuredkids.
Theultimatetest5
…SMACCDown!
Paediatrictraumacentersarethebest placeforinjuredkids.
Countdown
Aseverelyinjuredchildhasatraumatised family tocarefor.
Injuredchildrenneedmore thangood doctors,………. AND
Childspecificcareisunique topaediatriccentres,…… AND
Survivalisbetter (orasgood)inapaediatriccentre,… BUT
Thankyouforyourattention
Acknowledgements
Thankyou
Paediatrictraumacentersarethebest placeforinjuredkids.
Countdown
Aseverelyinjuredchildhasatraumatised family tocarefor.
Injuredchildrenneedmore thangood doctors,………. AND
Childspecificcareisunique topaediatriccentres,…… AND
Survivalisbetter (orasgood)inapaediatriccentre,… BUT
S T O P, D R O P & R U N ?
PEDIATRICTRAUMABYPASSANDREW SLOAS, DO, RDMS, FACEP, FAAEM, FAAP
ASSISTANTPROFESSOROFADULTANDPEDIATRICEMERGENCYMEDICINE
VANDERBILTUNIVERSITY
S U R E . . .
I T ’ S A LWAY S S A F E
http://goo.gl/tZxVYu
http://goo.gl/tZxVYu
CABO
ATLANTIS
http://goo.gl/a6D29Phttp://goo.gl/CROVdD http://goo.gl/zdMTZfhttp://goo.gl/irNhGH http://goo.gl/PF3QkL
S TAY & P L AY
S c o o p & R u n
10 5
30
6015
5
77
-5 7m i n u t e s
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Normotensive/Responsive
Circulation Hypotensive/Unresponsive
PediatricTraumaDestinationAlgorithm
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
W H E R E W E N E E D T O G O
Stripes~1981
http://goo.gl/XL5GxUhttp://goo.gl/HSPrro
http://goo.gl/GWj9Dn
http://goo.gl/cCwERJ
http://goo.gl/cCwERJ
http://goo.gl/cCwERJhttp://goo.gl/AQ4lRm
http://goo.gl/cCwERJ
http://goo.gl/lJQv2x https://goo.gl/RFEIaH
http://goo.gl/Dl2MjFDuke2013
Toronto, Prehosp Emerg Care. 2011
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