Screening adolescent patients admitted to the trauma service for high-risk behaviors: who is responsible?

BACKGROUND: Trauma remains the leading cause of death for adolescents in the United States. Adolescents are a hard to access medical population, with few opportunities for providers to screen for high-risk behaviors. The trauma team has a unique opportunity to screen for concurrent risk behaviors. The objective of this study was to assess surgeon knowledge, attitudes, and current practice of screening for high-risk behaviors in injured adolescents.
METHODS: From June 2007 to September 2007, a 16-item survey was mailed to 880 trauma surgeons assess their current screening practices of their adolescent patients (14-18 years); their perception of patients' risk taking; the perceived need for additional screening; and the surgeons' willingness to add routine screening to their workup.
RESULTS: The majority of trauma surgeons believed screening for risk behaviors in their adolescent patients was an important part of the trauma admission, although most thought it was not their personal responsibility. The highest rate of screening was for substance abuse, whereas the lowest was for gun ownership and sexual behavior. The majority of surgeons (74.4%) were willing to routinely consult specialists in adolescent medicine/pediatrics to assess for and manage risk behaviors in their adolescent trauma patients.
CONCLUSION: The majority of trauma surgeons agree that risk screening is an important part of the trauma treatment for adolescent patients and are interested in involving adolescent medicine and pediatric specialists to ensure adequate screening, management, and follow-up of risk behaviors in their patients.