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Characterization of the occult nature of frequently occurring pediatric motor vehicle crash injuries

•Pediatric trauma experts rated the occultness of pediatric injuries in 4 age groups.•Injuries were found to be more occult in younger age groups.•Abdominal injuries are the most occult across all pediatric age groups.•Thorax and spine injuries are more occult in 0–4 and 5–9 year olds.•Occult scores...

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Bibliographic Details
Published in:Accident analysis and prevention 2018-04, Vol.113, p.12-18
Main Authors: Doud, Andrea N., Schoell, Samantha L., Talton, Jennifer W., Barnard, Ryan T., Petty, John K., Stitzel, Joel D., Weaver, Ashley A.
Format: Article
Language:English
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Summary:•Pediatric trauma experts rated the occultness of pediatric injuries in 4 age groups.•Injuries were found to be more occult in younger age groups.•Abdominal injuries are the most occult across all pediatric age groups.•Thorax and spine injuries are more occult in 0–4 and 5–9 year olds.•Occult scores varied widely across and within AIS severity levels. Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC). The most frequent MVC injuries were determined for 0–4, 5–9, 10–14 and 15–18 year olds. For each age-specific injury, experts with pediatric trauma expertise were asked to rate the likelihood that the injury may be missed by first responders. An occult score (ranging from 0–1) was calculated by averaging and normalizing the responses of the experts polled. Evaluation of all injuries across all age groups demonstrated greater occult scores for the younger age groups compared to older age groups (mean occult score 0–4yo: 0.61 ± 0.23, 5–9yo: 0.53 ± 0.25, 10–14yo: 0.48 ± 0.23, and 15–18yo: 0.42 ± 0.22, p 
ISSN:0001-4575
1879-2057
DOI:10.1016/j.aap.2017.12.025