Management of head trauma in children on the paediatric emergency services. Medellín’s urgency units. January – June 2008

Abstract

Introduction: Head Trauma in children is a common reason for consulting the emergency department, although the severe TEC is more common in adults, the consequences are more severe in children.

Objective: To assess the state of knowledge of emergency medical care on the management of head trauma in children and to describe the characteristics of children with head trauma admitted to emergency rooms in the city of Medellin.

Methods: Descriptive study conducted in emergency departments of two tertiary care and two second level care hospitals of the city of Medellin during the first half of 2008 through two phases: the first one consisted of a survey of these medical services both knew what the guides handling head trauma in children. During the second phase, a review was conducted of the medical records of children who consulted to the emergency room because of a head trauma in these institutions during this period.

Results: The study group surveyed 68 physicians, 58.8% of which did not know of guides for the management of head trauma, 27.5% were unaware of the existence of protocols for management of head trauma in the workplace. In mild head trauma: 73.5% believe that the observation time should be 0-6 hours and 45.6% never used intravenous fluids in these patients. The 35.3% of respondents considered the use of steroids while 63.2% used mannitol and hypertonic saline in severe head trauma. Of the 145 medical records reviewed for children with head trauma, 66.9% were male and 52.4% in the age of 1 and 5 years, the mechanism of trauma was falling 75.2%. Glasgow Coma Scale score upon admission was 14/15 or 15/15 in 99.3% of patients.