Importance of transport in prehospital treatment of children with craniocerebral injuries

Introduction. In initial, prehospital, phase of treatment of the injured pediatric patient, transport plays an important role. Objective. The aim of this study was to determine the influence of an adequate transport on the survival rate and final outcome of patients with craniocerebral injuries. Method. This study is a clinical, partly prospective, partly retrospective study that includes 60 patients with isolated craniocerebral injuries, aged up to 17 years, and with Glasgow Coma Scale under 8, that did not require surgical treatment. The patients were divided in two groups each with 30 patients. The first group included patients that had adequate prehospital treatment. The second group included patients that had improper prehospital treatment. In both groups the emphasis was on the transport as an important step in initial treatment. Results. There was a statistically significant difference in respect to the mode of transport. In group I there was a greater number of patients transported by specialized emergency vehicles (93.3%) compared to the group II. There was also a difference regarding the time that had elapsed from the moment of injury to the moment of arrival to the hospital - a significantly shorter time in group I. In a group of patients that survived, a greater percentage of patients had been transported by specialized emergency vehicles compared to the group of patients that did not survive. Conclusion. Adequate transport improves the survival rate of the patients with craniocerebral injuries. Also the time that has elapsed from the moment of injury to the moment of arrival to the hospital also influences the survival rate, but the final outcome, too. Transport of pediatric patients is globally neglected. Transport of unstable, critically ill and injured patients accompanied by inexperienced and unspecialized staff is followed an increased mortality rate. .