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Emergency department imaging of pediatric trauma patients during combat operations in Iraq and Afghanistan

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Abstract

Background

Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population.

Objective

The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan.

Materials and methods

We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. We retrieved ED data on ultrasound (US), radiographic and computed tomography (CT) studies.

Results

During the study period, there were 3,439 pediatric encounters, which represented 8.0% of all military hospital trauma admissions. ED providers obtained a total of 12,376 imaging studies on 2,920 (84.9%) children. Of the 12,376 imaging studies, 1,341 (10.8%) were US, 4,868 (39.3%) were radiographic and 6,167 (49.8%) were CT exams. Most children undergoing radiographic evaluation were boys (77.8%) and located in Afghanistan (70.4%), and they sustained penetrating injuries (68.0%). Children who underwent imaging had higher composite injury severity scores in comparison to those who did not undergo imaging (10 versus 9).

Conclusion

Military health care providers frequently utilized radiographic studies in the evaluation of pediatric trauma casualties in Iraq and Afghanistan. Deployed military hospitals that treat children would benefit from dedicated pediatric-specific imaging training and protocols.

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Acknowledgments

We would like to thank the Joint Trauma System Data Analysis Branch for their efforts with data acquisition.

Author information

Authors and Affiliations

  1. 28th Combat Support Hospital, Bldg. A-1985 Longstreet Road, Fort Bragg, NC, 28310, USA

    Jason F. Naylor

  2. San Antonio Military Medical Center, JBSA Fort Sam Houston, San Antonio, TX, USA

    Michael D. April, Jamie L. Roper & Steven G. Schauer

  3. Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA

    Guyon J. Hill

  4. Dell Children’s Medical Center, Austin, TX, USA

    Guyon J. Hill

  5. Defense Health Agency National Capital Region Medical Directorate, Bethesda, MD, USA

    Paul Clark

  6. U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX, USA

    Steven G. Schauer

  7. 59th Medical Wing, JBSA Lackland Air Force Base, Lackland, TX, USA

    Steven G. Schauer

Authors
  1. Jason F. Naylor
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  2. Michael D. April
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  3. Jamie L. Roper
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  4. Guyon J. Hill
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  5. Paul Clark
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  6. Steven G. Schauer
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Correspondence to Jason F. Naylor.

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Opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Air Force, the Department of the Army or the Department of Defense.

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Naylor, J.F., April, M.D., Roper, J.L. et al. Emergency department imaging of pediatric trauma patients during combat operations in Iraq and Afghanistan. Pediatr Radiol 48, 620–625 (2018). https://doi.org/10.1007/s00247-017-4065-9

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  • DOI: https://doi.org/10.1007/s00247-017-4065-9

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