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Fall Injuries in the Pediatric Population: Safer and Most Cost-Effective Management

Pillai, Srikumar B. MD; Bethel, Colin A. I. MD; Besner, Gail E. MD; Caniano, Donna A. MD; Cooney, Donald R. MD

The Journal of Trauma: Injury, Infection, and Critical Care: June 2000 - Volume 48 - Issue 6 - p 1048-1051
Annual Meeting Articles

Background At our children’s hospital, 30% of all trauma admissions are from falls. The aim of this study was to outline inefficiencies and unnecessary costs incurred in the care of these patients.

Methods The charts of 127 children admitted for falls (height ≥ 9 feet) from 1993 to 1996 were reviewed. Patient demographics, injuries, and treatment costs were recorded and analyzed.

Results Fifty-seven children (45%) were evaluated at an outside facility before transfer. Of these, 73% had injuries requiring treatment at the pediatric center. Local hospital work-up resulted in an average treatment delay of 4.5 hours. Additionally, significant cost was incurred by duplication of radiographic studies, the majority of which were normal.

Conclusion Improved and more cost-effective care in pediatric falls can be ensured by immediate transfer of patients with significant injuries, omission of radiographs before transfer, and avoidance of multiple routine x-ray films, the majority of which are normal.

From the Division of Pediatric Surgery (S.B.P., G.E.B., D.A.C., D.R.C.), The Ohio State University, Columbus, Ohio, and Division of Pediatric Surgery (C.A.I.B.), The University of New Jersey School of Medicine and Dentistry, Newark, New Jersey.

Address for reprints: Donna A. Caniano, MD, Division of Pediatric Surgery, Children’s Hospital, 700 Children’s Drive, ED-379, Columbus, OH 43205-2696.

Submitted for publication September 25, 1999.

Accepted for publication December 6, 1999.

Presented at the 11th Annual Meeting of the Eastern Association for the Surgery of Trauma, January 14–17, 1998, Sanibel, Florida.

© 2000 Lippincott Williams & Wilkins, Inc.