• Pediatric emergency care · Nov 2023

    Determining the Association Between Emergency Department Crowding and Debriefing After Pediatric Trauma Resuscitations.

    • Pamela Soriano, Jessica Kanis, Kamal Abulebda, Sandra Schwab, R Lane Coffee, and Brian Wagers.
    • From the Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
    • Pediatr Emerg Care. 2023 Nov 1; 39 (11): 848852848-852.

    BackgroundDebriefing in the pediatric emergency department (PED) is an invaluable tool to improve team well-being, communication, and performance. Despite evidence, surveys have reported heavy workload as a barrier to debriefing leading to missed opportunities for improvement in an already busy ED. The study aims to determine the association between the incidence of debriefing after pediatric trauma resuscitations and PED crowding.MethodsA total of 491 Trauma One activations in Riley Children's Hospital Pediatric Emergency Department that presented between April 2018 to December 2019 were included in the study. Debriefing documentations, patient demographics, time and date of presentation, mechanism of injury, injury severity score, disposition from PED, and length of stay (LOS) were collected and analyzed. The National Emergency Department Overcrowding Scale score at arrival, Average LOS, total PED census, total PED waiting room census, and rates of left without being seen were compared between groups.ResultsOf 491 Trauma One activations presented to our PED, 50 (10%) trauma evaluations had documented debriefing. The National Emergency Department Overcrowding Scale score at presentation was significantly lower in those with debriefing versus without debriefing. In addition, the PED hourly census, waiting room census, average LOS, and left without being seen were also significantly lower in the group with debriefing. In addition, trauma cases with debriefing had a higher proportion of patients with profound injuries and discharges to the morgue.ConclusionsPediatric emergency department crowding is a significant barrier to debriefing after trauma resuscitations. However, profound injuries and traumatic pediatric deaths remain the strongest predictors in conducting debriefing regardless of PED crowding status.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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