Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre
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Transcript of Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre
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DrWarwickTeagueDirectorofTraumaServicesConsultantPaediatric&BurnsSurgeon
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Matterofdoordie?1
Evidence?Keyreferenceswillbeprovided.ShowmeyoursandI’llshowyoumine!
• Survivalinpaediatricvsadulttraumacentres?CompellingdatainfavourConfusingqualificationsGofigure…
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• Survivalinpaediatricvsadulttraumacentres?CompellingdatainfavourConfusingqualificationsGofigure…
Survivalisbetter (orasgood)inapaediatriccentre,…BUT
Conclusion?
Matterofdoordie?1
Evidence?Keyreferenceswillbeprovided.ShowmeyoursandI’llshowyoumine!
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• ChildrenwhosurviveseveretraumaneedhighestqualitycareIatrogenicmorbidityapplyingadultservicestopaediatricpatientsExamplesincludeCTradiation,splenectomy
Matterorlifeordeath2
Relax,…IfIgaveyouallthereferenceshereyoumightnotcometothedebate!
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• ChildrenwhosurviveseveretraumaneedhighestqualitycareIatrogenicmorbidityapplyingadultservicestopaediatricpatientsExamplesincludeCTradiation,splenectomy
.
Childspecificcareisunique topaediatriccentres,…AND
Conclusion
Matterorlifeordeath2
Relax,…IfIgaveyouallthereferenceshereyoumightnotcometothedebate!
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• Qualityofcareisnotjustaboutclinicalcapacityorcompetence,…QualityofexperienceKid-centeredenvironment
Matteroflaughinlife3
Itwouldn’t beapaediatrictalkwithout afewcartoongraphics.
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“ClownDoctorsnowtouchthelivesofover 100,000peopleeveryyear. Wearenowpartofhospitallifeinall majorchildren'shospitalsaroundAustralia.”
www.humourfoundation.com.au
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• Qualityofcareisnotjustaboutclinicalcapacityorcompetence,…QualityofexperienceKid-centeredenvironment
.
Injuredchildrenneedmore thangood doctors,…AND
Matteroflaughinlife3
Conclusion?
Itwouldn’t beapaediatrictalkwithout afewcartoongraphics.
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• Whoislookingaftertheparentsandsiblingsinyouradulttraumacentre?FamilysupportworkerRealneeds,realdeficits
Toosentimental?Buildabridge.
Cryandyoucryalone?4
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• Whoislookingaftertheparentsandsiblingsinyouradulttraumacentre?FamilysupportworkerRealneeds,realdeficits
Conclusion?
Toosentimental?Buildabridge.
Aseverelyinjuredchildhasatraumatised family tocarefor.
Cryandyoucryalone?4
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• WherewouldItakemyownseverelyinjuredchild?NobrainerNoexceptions?!?ExceptionsareOK
Youcanfindsflawsinmostarguments,butasoftenasnot,you’vemissedthepoint,…itisaCHILD!
Theultimatetest5
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• WherewouldItakemyownseverelyinjuredchild?NobrainerNoexceptions?!?ExceptionsareOK
.Conclusion?
Youcanfindsflawsinmostarguments,butasoftenasnot,you’vemissedthepoint,…itisaCHILD!
Paediatrictraumacentersarethebest placeforinjuredkids.
Theultimatetest5
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…SMACCDown!
Paediatrictraumacentersarethebest placeforinjuredkids.
Countdown
Aseverelyinjuredchildhasatraumatised family tocarefor.
Injuredchildrenneedmore thangood doctors,………. AND
Childspecificcareisunique topaediatriccentres,…… AND
Survivalisbetter (orasgood)inapaediatriccentre,… BUT
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Thankyouforyourattention
Acknowledgements
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Thankyou
Paediatrictraumacentersarethebest placeforinjuredkids.
Countdown
Aseverelyinjuredchildhasatraumatised family tocarefor.
Injuredchildrenneedmore thangood doctors,………. AND
Childspecificcareisunique topaediatriccentres,…… AND
Survivalisbetter (orasgood)inapaediatriccentre,… BUT
![Page 26: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/26.jpg)
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S T O P, D R O P & R U N ?
PEDIATRICTRAUMABYPASSANDREW SLOAS, DO, RDMS, FACEP, FAAEM, FAAP
ASSISTANTPROFESSOROFADULTANDPEDIATRICEMERGENCYMEDICINE
VANDERBILTUNIVERSITY
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S U R E . . .
I T ’ S A LWAY S S A F E
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http://goo.gl/tZxVYu
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http://goo.gl/tZxVYu
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CABO
ATLANTIS
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http://goo.gl/a6D29Phttp://goo.gl/CROVdD http://goo.gl/zdMTZfhttp://goo.gl/irNhGH http://goo.gl/PF3QkL
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S TAY & P L AY
S c o o p & R u n
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10 5
30
6015
5
77
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-5 7m i n u t e s
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AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Normotensive/Responsive
Circulation Hypotensive/Unresponsive
PediatricTraumaDestinationAlgorithm
![Page 39: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/39.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 40: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/40.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 41: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/41.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
Circulation
PediatricTraumaDestinationAlgorithm
DamageControl
Hospital (DCH)
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 42: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/42.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 43: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/43.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 44: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/44.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 45: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/45.jpg)
AirwayApneicLabored
PhysiologicBarrierSGA/BVM/ET&Hypoxic
Patent
Bleeding
Controlled
HemorrhageNOTcontrollable
TraumaCenter
DamageControl
Hospital (DCH)
Circulation
PediatricTraumaDestinationAlgorithm
Normotensive/Responsive
Hypotensive/Unresponsive
![Page 46: Warwick Teague vs Andy Sloas - All Paeds Trauma Should be Managed in a Paediatric Trauma Centre](https://reader031.fdocuments.in/reader031/viewer/2022030212/589f29601a28ab4d568b4b0f/html5/thumbnails/46.jpg)
W H E R E W E N E E D T O G O
Stripes~1981
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http://goo.gl/XL5GxUhttp://goo.gl/HSPrro
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http://goo.gl/Dl2MjFDuke2013
Toronto, Prehosp Emerg Care. 2011