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Child's Nervous System

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01-11-2020 | Central Nervous System Trauma | Original Article

Survey of resources available to implement severe pediatric traumatic brain injury management guidelines in low and middle-income countries

Authors: Gavin Wooldridge, Andreas Hansmann, Omer Aziz, Nicole O’Brien

Published in: Child's Nervous System | Issue 11/2020

Abstract

Purpose

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with a disproportionately high burden in low-middle income countries. Guideline implementation has been associated with mortality reduction in high-income countries (HIC), but it is not known if hospitals in low and middle-income countries possess the resources to implement the pre-hospital TBI guidelines and the guidelines for the management of severe pediatric traumatic brain injury.

Method

An anonymous online survey was undertaken by a range of health care professionals currently managing children with severe TBI in low to middle-income countries. A variety of international and national pediatric, intensive care, and neurological societies assisted in the survey distribution. Thirty-eight questions were included to evaluate patient care and the provider’s perceptions of their resources available to implement the pre-hospital specific TBI and current pediatric severe TBI guidelines.

Results

Two hundred and forty-seven hospitals were represented from 68 countries. Fifty percent of LMIC hospitals that responded had the resources to implement 13 of 15 guidelines for the pediatric component of pre-hospital management for TBI and all baseline care recommendations. First tier therapies including the intracranial pressure (ICP) and cerebral perfusion pathways (CPP), however, demonstrated low capacity for uptake with 21.5% and 38.5% of surveyed hospitals possessing sufficient resources to follow the recommended pathways.

Conclusion

Pediatric TBI ICP/CPP management guidelines require numerous resources not widely sourced in LMIC. The creation of international guidelines that outline recommendations of care for LMIC may benefit patient care and outcomes in these settings.

Available only for authorised users

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Title: Survey of resources available to implement severe pediatric traumatic brain injury management guidelines in low and middle-income countries
Authors: Gavin Wooldridge
Andreas Hansmann
Omer Aziz
Nicole O’Brien
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Intracranial Hypertension
Care
Published in: Child's Nervous System / Issue 11/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04603-9

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Survey of resources available to implement severe pediatric traumatic brain injury management guidelines in low and middle-income countries

Abstract

Purpose

Method

Results

Conclusion

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Abstract

Purpose

Method

Results

Conclusion

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