Tags

Type your tag names separated by a space and hit enter

Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan.
Mil Med. 2020 01 07; 185(Suppl 1):73-76.MM

Abstract

BACKGROUND

Infectious complications of war wounds are a significant source of mortality and morbidity. Tactical Combat Casualty Care (TCCC) guidelines recommend prehospital moxifloxacin, ertapenem, or cefotetan for "all open combat wounds." We describe the prehospital administration of antibiotics to pediatric trauma patients.

METHODS

We queried the Department of Defense Trauma Registry for all pediatric subjects admitted to United States and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016.

RESULTS

During this time, there were 3,439 pediatric encounters which represented 8.0% of all admissions. Prehospital providers administered a total of 216 antibiotic doses to 210 subjects. Older children received antibiotics more frequently than younger children, were more likely to be male, located in Afghanistan, and injured by explosive with the majority surviving to hospital discharge. Cefazolin and ceftriaxone were the most frequently utilized antibiotics.

CONCLUSIONS

The most frequently administered antibiotics were cephalosporins. TCCC recommended agents for adult prehospital wound prophylaxis were infrequently administered to pediatric casualties. Administration rates of pediatric prehospital wound prophylaxis may be improved with pediatric-specific TCCC guidelines recommending cephalosporins as first-line agents, fielding of a TCCC-oriented Broselow tape, and training prehospital providers on administration of antimicrobials.

Authors+Show Affiliations

Madigan Army Medical Center, 9040 Jackson Avenue, Joint Base Lewis-McChord, Tacoma, WA 98431.San Antonio Military Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio, San Antonio, TX 78234.Carl R. Darnall Army Medical Center, 36065 Santa Fe Avenue, Fort Hood, TX 76544.Madigan Army Medical Center, 9040 Jackson Avenue, Joint Base Lewis-McChord, Tacoma, WA 98431. US Army Institute of Surgical Research, 3698 Chambers Pass Suite B, Joint Base San Antonio, San Antonio, TX 78234. 59th Medical Wing, 1100 Wilford Hall Loop, Joint Base San Antonio, San Antonio, TX 78236.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32074367

Citation

Naylor, Jason F., et al. "Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan." Military Medicine, vol. 185, no. Suppl 1, 2020, pp. 73-76.
Naylor JF, April MD, Hill GJ, et al. Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan. Mil Med. 2020;185(Suppl 1):73-76.
Naylor, J. F., April, M. D., Hill, G. J., & Schauer, S. G. (2020). Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan. Military Medicine, 185(Suppl 1), 73-76. https://doi.org/10.1093/milmed/usz285
Naylor JF, et al. Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan. Mil Med. 2020 01 7;185(Suppl 1):73-76. PubMed PMID: 32074367.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pediatric Prehospital Wound Prophylaxis in Iraq and Afghanistan. AU - Naylor,Jason F, AU - April,Michael D, AU - Hill,Guyon J, AU - Schauer,Steven G, PY - 2019/01/10/received PY - 2019/07/23/revised PY - 2019/07/23/accepted PY - 2020/2/20/entrez PY - 2020/2/20/pubmed PY - 2020/2/20/medline SP - 73 EP - 76 JF - Military medicine JO - Mil Med VL - 185 IS - Suppl 1 N2 - BACKGROUND: Infectious complications of war wounds are a significant source of mortality and morbidity. Tactical Combat Casualty Care (TCCC) guidelines recommend prehospital moxifloxacin, ertapenem, or cefotetan for "all open combat wounds." We describe the prehospital administration of antibiotics to pediatric trauma patients. METHODS: We queried the Department of Defense Trauma Registry for all pediatric subjects admitted to United States and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. RESULTS: During this time, there were 3,439 pediatric encounters which represented 8.0% of all admissions. Prehospital providers administered a total of 216 antibiotic doses to 210 subjects. Older children received antibiotics more frequently than younger children, were more likely to be male, located in Afghanistan, and injured by explosive with the majority surviving to hospital discharge. Cefazolin and ceftriaxone were the most frequently utilized antibiotics. CONCLUSIONS: The most frequently administered antibiotics were cephalosporins. TCCC recommended agents for adult prehospital wound prophylaxis were infrequently administered to pediatric casualties. Administration rates of pediatric prehospital wound prophylaxis may be improved with pediatric-specific TCCC guidelines recommending cephalosporins as first-line agents, fielding of a TCCC-oriented Broselow tape, and training prehospital providers on administration of antimicrobials. SN - 1930-613X UR - https://www.unboundmedicine.com/medline/citation/32074367/Pediatric_Prehospital_Wound_Prophylaxis_in_Iraq_and_Afghanistan L2 - https://academic.oup.com/milmed/article-lookup/doi/10.1093/milmed/usz285 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.