Kevin N Johnson1, Alaina Raetz2, Melissa Harte2, Lisa E McMahon3, Victoria Grandsoult2, Pamela Garcia-Filion4, David M Notrica5. 1. Department of General Surgery, Mayo Clinic, Phoenix, Arizona. 2. Trauma Center, Phoenix Children's Hospital, Phoenix, Arizona. 3. Department of General Surgery, Mayo Clinic, Phoenix, Arizona; Trauma Center, Phoenix Children's Hospital, Phoenix, Arizona; Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona. 4. Trauma Center, Phoenix Children's Hospital, Phoenix, Arizona; Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona. 5. Department of General Surgery, Mayo Clinic, Phoenix, Arizona; Trauma Center, Phoenix Children's Hospital, Phoenix, Arizona; Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona. Electronic address: dnotrica@phoenixchildrens.com.
Abstract
INTRODUCTION: Alcohol use is a risk factor for adult trauma. Alcohol may significantly influence pediatric trauma risk, but literature is sparse. The aim of this study was to examine the impact of alcohol use screening in pediatric trauma patients. METHODS: A retrospective review was performed of all trauma patients to identify those undergoing CRAFFT alcohol screening assessment between July 1, 2009, and January 31, 2011. Inclusion criteria involved screening of level 1 or 2 trauma activations for patients greater than 12 years. RESULTS: During the study period, 232 patients were eligible for screening, of which 51% (n=118) were screened. Among the patients screened, 21 (18%) had a positive screen (mean age 14.6 years, range 13-16). Twenty patients were referred for further counseling. Sixteen males and 5 females screened positive during the study. The most common mechanism of injury in the positive screen patients was motor vehicle or ATV accident (n=9), followed by assault (n=6), and motor versus pedestrian collision (n=2). Of the 21 patients who screened positive, 10 had positive blood alcohol content (BAC) or urine drug screen (UDS) at the time of injury. No patients with a positive screen returned during the study as a trauma patient. CONCLUSION: Alcohol and drug screening for injured pediatric trauma patients is frequently omitted despite policy-required screening. Of those patients screened, 18% admitted to risky alcohol or drug-related behaviors or had positive BAL or UDS at presentation. Pediatric trauma screening for risky alcohol use identifies a significant number of children. Alcohol and drug screening in pediatric trauma appears over age 13 years to have a yield which justifies continued screening. Alcohol related trauma recidivism, however, does not seem common.
INTRODUCTION:Alcohol use is a risk factor for adult trauma. Alcohol may significantly influence pediatric trauma risk, but literature is sparse. The aim of this study was to examine the impact of alcohol use screening in pediatric traumapatients. METHODS: A retrospective review was performed of all traumapatients to identify those undergoing CRAFFT alcohol screening assessment between July 1, 2009, and January 31, 2011. Inclusion criteria involved screening of level 1 or 2 trauma activations for patients greater than 12 years. RESULTS: During the study period, 232 patients were eligible for screening, of which 51% (n=118) were screened. Among the patients screened, 21 (18%) had a positive screen (mean age 14.6 years, range 13-16). Twenty patients were referred for further counseling. Sixteen males and 5 females screened positive during the study. The most common mechanism of injury in the positive screen patients was motor vehicle or ATV accident (n=9), followed by assault (n=6), and motor versus pedestrian collision (n=2). Of the 21 patients who screened positive, 10 had positive blood alcohol content (BAC) or urine drug screen (UDS) at the time of injury. No patients with a positive screen returned during the study as a traumapatient. CONCLUSION:Alcohol and drug screening for injured pediatric traumapatients is frequently omitted despite policy-required screening. Of those patients screened, 18% admitted to risky alcohol or drug-related behaviors or had positive BAL or UDS at presentation. Pediatric trauma screening for risky alcohol use identifies a significant number of children. Alcohol and drug screening in pediatric trauma appears over age 13 years to have a yield which justifies continued screening. Alcohol related trauma recidivism, however, does not seem common.
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