NC West Virginia News

West Virginia University researchers have developed a new tool to improve the assessment of children with traumatic injuries. The measure aims to ensure that young patients receive the most effective treatment by accurately predicting which ones would benefit from being taken to a Level 1 trauma center.

Tanner Smida, an MD/PhD student focusing on emergency medicine, stated, “This tool we’ve evaluated is not only accurate in predicting which pediatric patients are going to benefit from going to a Level 1 trauma center, but it’s also simpler than ones that have been previously proposed so a paramedic can use it in the back of an ambulance.”

The study was conceptualized by Smida and WVU School of Medicine's Dr. James Bardes and Dr. Patrick Bonasso. It addresses the triage needs of children injured in rural areas far from trauma centers but is applicable in any setting requiring critical care assessment.

The Journal of Trauma and Acute Care Surgery recognized this study as one of the best for 2024. The research builds on Bardes’ earlier work on adult traumatic injuries, especially those occurring in rural states. Brad Price from WVU's John Chambers College also contributed as a co-author.

Smida emphasized the importance of first responders making informed decisions about where to take injured children: “This tool gives us a simple and highly accurate way to identify high-risk pediatric trauma patients and send them to the right place, which can have an impact on their outcome.”

The team examined the reverse shock index (rSIM) score and Glasgow Coma Scale (GCS) motor skills component. Dr. Bardes explained, “We know the motor component is the most predictive, the most consistent across the age range for children.”

Researchers analyzed data from ages 1-16 using information like age, gender, and injury severity from the National Trauma Data Bank.

Smida described how first responders could calculate an rSIM score using blood pressure divided by heart rate multiplied by GCS score: “Imagine...a 6-year-old boy being struck by a car at low speed...A few taps on a phone calculator...yields an rSIM score of 4.6.”

Emergency personnel would then communicate with WVU Medical Command regarding accident details and rSIM scores.

“In this scenario,” Smida said, “we can imagine that...the optimal threshold value is five.” If below this threshold at 4.6, specialized care may be necessary due to serious injury risk.

Smida highlighted proper care level selection: overtriaging or undertriaging could either impose unnecessary burdens or deny essential treatment access.

Results showed accurate predictions for survival chances and need for intensive interventions like surgery or blood transfusions.

Dr. Bonasso noted hospital preparation benefits: “We’re talking about interventions that happen in the emergency department...or whether there’s a need for procedures in the operating room.”

Future steps include educating pre-hospital providers about using this tool effectively within West Virginia and beyond while encouraging further research based on these findings.

WVU plans collaboration with ATOMAC+ Pediatric Trauma Research Network for expanded studies soon.