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Emerg Med Australas · Aug 2008
Paediatric and adolescent horse-related injuries: does the mechanism of injury justify a trauma response?
- John A Craven.
- Department of Paediatric Emergency Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia. jcraven@ausdoctors.net
- Emerg Med Australas. 2008 Aug 1;20(4):357-62.
ObjectiveTo identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries.MethodsA retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003.ResultsA total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1-17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations.ConclusionAlthough horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.
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