Pediatric Trauma Cases Spike During Pandemic

Pediatric Trauma Cases Spike During Pandemic
Injury represents growing proportion of ED visits.

Monroe Carell Jr. Children’s Hospital at Vanderbilt reported just 6,393 pediatric ED visits in 2020 – half the number seen in previous years. While the total number of pediatric ED visits dropped, the proportion of visits attributable to trauma rose significantly, according to new data published in Hospital Pediatrics.

Pediatric trauma accounted for almost a third of the visits between March and May 2020. The researchers attribute the large proportion of trauma visits to school closings due to the COVID-19 pandemic.

“Kids are supposed to be in school, and instead are at home playing outside, often unsupervised,” said lead author Zaid Haddadin, M.D., a postdoctoral research fellow at Vanderbilt. “School closings brought trauma visits to the ED in spring, instead of summer.”

“School closings brought trauma visits to the ED in spring, instead of summer.”

Trauma Trends 

Children’s Hospital researchers found traumatic injury comprised 26.1 percent of all ED visits in 2020, up from 20.8 percent in 2018. Specifically, the proportion of ED visits due to all-terrain vehicle, dirt bike and motorcycle injuries doubled.

A positive finding was that intentional trauma decreased. “Intentional and animal-related trauma went down compared to previous years,” Haddadin noted. “One potential explanation is that because of stay-at-home orders, more than one caregiver is in the house with increased supervision of young children. We think this reflects fewer child abuse-related injuries, suicides, assaults and other intentional traumas.”

ARIs Plummet

The report also describes a precipitous drop – 58 percent – in visits for acute respiratory illnesses (ARIs) between 2018 and 2020. The data suggest social distancing and public health measures to prevent SARS-CoV-2 infection may be keeping other ARIs at bay.

“We have to look at the data in upcoming seasons from different geographic sites to know for sure,” Haddadin said. “Non-medical interventions can be considered an adjunct to medical treatments to help reduce the burden of respiratory viral infections in children in future epidemics and pandemics.”

Decreases in the total number and proportion of ARIs may also be due to changes in health care-seeking behavior, note the authors, or access limitations during the pandemic.

Room for Improvement

The report bolstered anecdotal evidence from Vanderbilt co-authors Natasha Halasa, M.D., and Harold “Bo” Lovvorn, M.D., who noticed ARIs and trauma visits were not following their typical seasonal trends.

“It was odd,” Lovvorn said. “We were seeing summertime trauma volume that typically occurs during the weekends, but now it was during the middle of the week. As the numbers increased, we started to take more notice.”

“We were seeing summertime trauma volume that typically occurs during the weekends, but now it was during the middle of the week.”

The researchers say that although total pediatric ED visits went down, there is room for improvement in the proportion of visits that are due to accidental trauma. They suggest more supervision and community vigilance for outdoor activities. Preventative measures can be simple, they say. Said Haddadin, “Practice safer activities and wear helmets, for one.”