The "non-preventable" preventable transfer? An analysis of the care from support services that injured children transferred to a level 1 pediatric trauma center receive

J Pediatr Surg. 2021 Sep;56(9):1638-1642. doi: 10.1016/j.jpedsurg.2020.10.017. Epub 2020 Oct 25.

Abstract

Purpose: Almost 30% of pediatric trauma transfers to our facility have previously been shown to be potentially preventable transfers (PT). However, we sought to evaluate what care from support services these PT received during admission.

Methods: Traumatically injured children transferred between January 2014 and June 2019 were retrospectively analyzed. A PT was defined as a child who was discharged within 36 h of arrival without surgical intervention or advanced imaging studies. PT that received support services were compared to those that did not to determine which patients may benefit from these services were their transfers prevented.

Results: There were 3212 transfers, and 927 (29%) were PT. When compared to non-PT, PT were younger, closer to our hospital, and had a lower ISS, extremity or C-spine injury, or assault/non-accidental trauma mechanism. PT were less likely to have a chest injury or a CT at the referring hospital. Of the PT, 30% had a support service consulted. PT with higher ISS or a head injury was more likely to receive a consultation with a support service.

Conclusions: A significant proportion of these "preventable" transfers still receive important care from support services during their admission.

Type of study: Retrospective study.

Level of evidence: III.

Keywords: Concussion; Interfacility transfer; Telehealth; Telemedicine; Teletrauma.

MeSH terms

  • Child
  • Humans
  • Patient Discharge
  • Patient Transfer
  • Referral and Consultation
  • Retrospective Studies
  • Trauma Centers*
  • Wounds and Injuries* / therapy