A Novel Approach to Assessing Head Injury Severity in Pediatric Patient Falls

Document Type

Article

Publication Date

12-22-2017

Publication Title

Journal of Pediatric Health Care

Volume

32

Issue

2

First page number:

e59

Last page number:

e66

Abstract

Introduction Pediatric patient falls with head-to-floor impact have the greatest potential for injury. Methods An objective measure of head injury severity, the Head Injury Criterion (HIC15), was calculated from anthropometric and biomechanical components of patient falls. A secondary aim was to compare HIC15levels with the hospital's subjective assignment of level of harm (1-9 scale) used for regulatory reports. Results Adverse event reports yielded a sample of 49 falls from heights of 72.5 to 1793.0 cm by children ages 11 months through 17 years. Contact velocity from beginning to end was 2.81 to 6.16 ms. Mean acceleration was 19.5 to 95.3g. HIC15 levels of impact ranged from 26.4 to 1,330.0, and mean force upon contact was 2.0 to 9.8 N/kg body mass. Seven (14.3%) children's HIC15 levels exceeded age-specific thresholds, with no follow-up scheduled. Hospital-assigned levels of harm were not correlated with HIC15 levels (r = .23, R2 = .05, p = .12). Discussion A point-of-care computerized HIC15 algorithm would be useful for diagnostic and follow-up decisions.

Keywords

Biomechanics; Concussion; Falls; Traumatic brain injury

Disciplines

Investigative Techniques | Neurology | Pediatrics | Trauma

Language

English

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