Prehospital pediatric trauma classification (PHPTC) as a tool for optimizing trauma care resources in the city of São Paulo, Brazil

Abstract

PURPOSE: To evaluate the pediatric prehospital care in São Paulo, the databases from basic life support units (BLSU) and ALSU, and to propose a simple and effective method for evaluating trauma severity in children at the prehospital phase. METHODS: A single firemen headquarter coordinates all prehospital trauma care in São Paulo city. Two databases were analyzed for children from 0 to 18 years old between 1998 and 2001: one from the Basic Life Support Units (BLSU - firemen) and one from the Advanced Life Support Units (ALSU - doctor and firemen). During this period, advanced life support units provided medical reports from 604 victims, while firemen provided 12.761 reports (BLSU+ALSU). Pre-Hospital Pediatric Trauma Classification is based on physiological status, trauma mechanism and anatomic injuries suggesting high energy transfer. In order to evaluate the proposed classification, it was compared to the Glasgow Coma Score and to the Revised Trauma Score. RESULTS: There was a male predominance in both databases and the most common trauma mechanism was transport related, followed by falls. Mortality was 1.6% in basic life support units and 9.6% in ALSU. There was association among the proposed score, the Glasgow Coma Score and to the Revised Trauma Score (p<0.0001). CONCLUSION: Pre-Hospital Pediatric Trauma Classification is a simple and reliable method for assessment, triage and recruitment of pediatric trauma resources.