Frequency of and factors associated with emergency department intracranial pressure monitor placement in severe paediatric traumatic brain injury

Nithya Kannan*, Alex Quistberg, Jin Wang, Jonathan I. Groner, Richard B. Mink, Mark S. Wainwright, Michael J. Bell, Christopher C. Giza, Douglas F. Zatzick, Richard G. Ellenbogen, Linda Ng Boyle, Pamela H. Mitchell, Monica S. Vavilala

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: To examine the frequency of and factors associated with emergency department (ED) intracranial pressure (ICP) monitor placement in severe paediatric traumatic brain injury (TBI). Methods: Retrospective, multicentre cohort study of children <18 years admitted to the ED with severe TBI and intubated for >48 hours from 2007 to 2011. Results: Two hundred and twenty-four children had severe TBI and 75% underwent either ED, operating room (OR) or paediatric intensive care unit (PICU) ICP monitor placement. Four out of five centres placed ICP monitors in the ED, mostly (83%) fibreoptic. Nearly 40% of the patients who received ICP monitors get it placed in the ED (29% overall). Factors associated with ED ICP monitor placement were as follows: age 13 to <18 year olds compared to infants (aRR 2.02; 95% CI 1.37, 2.98), longer ED length of stay (LOS) (aRR 1.15; 95% CI 1.08, 1.21), trauma centre designation paediatric only I/II compared to adult/paediatric I/II (aRR 1.71; 95% CI 1.48, 1.98) and higher mean paediatric TBI patient volume (aRR 1.88;95% CI 1.68, 2.11). Adjusted for centre, higher bedside ED staff was associated with longer ED LOS (aRR 2.10; 95% CI 1.06, 4.14). Conclusion: ICP monitors are frequently placed in the ED at paediatric trauma centres caring for children with severe TBI. Both patient and organizational level factors are associated with ED ICP monitor placement.

Original languageEnglish (US)
Pages (from-to)1745-1752
Number of pages8
JournalBrain Injury
Volume31
Issue number13-14
DOIs
StatePublished - Dec 6 2017

Keywords

  • Emergency department
  • intracranial pressure monitor
  • paediatrics
  • traumatic brain injury

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Frequency of and factors associated with emergency department intracranial pressure monitor placement in severe paediatric traumatic brain injury'. Together they form a unique fingerprint.

Cite this