Department of Paediatric Emergency Medicine, Children's Health Ireland Crumlin, Dublin, Ireland.
School of Medicine, Women's and Children's Health, University College Dublin, Dublin, Ireland.
Ir J Med Sci. 2022 Apr;191(2):589-595. doi: 10.1007/s11845-021-02593-4. Epub 2021 Mar 20.
The SARS-CoV-2 pandemic and government-enforced restrictions have impacted medical practices.
The aim of our study was to investigate the impact SARS-CoV-2 and public health restrictions had on trauma presentations to a regional paediatric emergency service.
We carried out a multisite retrospective longitudinal study of all paediatric ED attendances from 2018 including 13 March to 7 June 2020. This aligned with the initial government-enforced public health phases: delay phase, mitigation phase and reopening phase 1.
There were 7975 total regional attendances during government-enforced restrictions. This represents 17.5% and 15.6% reductions in site attendances when compared with the two previous years. Regional attendances reduced by 52.5% in 2020 compared with 2018 and 50.9% compared with 2019. Following an initial reduction in injury attendances at the beginning of the 'lockdown' (p = 0.076), the number of injuries consistently grew as weeks progressed (p < 0.05), reaching a peak of 44.6% of all attendances. As restrictions eased, the most common location where injuries occurred moved to areas outside the home (p < 0.000). There was a significant change in injury type, final disposition and device-associated injury (p < 0.05). Wheeled recreational devices were associated with over 20% of all injuries by reopening phase 1.
This study reveals that total attendances and total injuries reduced during initial phases of the lockdown. This was followed by a significant increase in injury presentations, which reached a peak of 44.6% of all attendances. We identified potential modifiable characteristics of paediatric trauma which can be addressed by future public health strategies.
SARS-CoV-2 大流行和政府实施的限制措施对医疗实践产生了影响。
本研究旨在调查 SARS-CoV-2 和公共卫生限制措施对区域性儿科急诊服务中创伤表现的影响。
我们对 2018 年 3 月 13 日至 2020 年 6 月 7 日期间所有儿科 ED 就诊进行了多站点回顾性纵向研究。这与政府实施的公共卫生阶段一致：延迟阶段、缓解阶段和 1 阶段重新开放。
在政府实施限制期间，共有 7975 例区域性就诊。与前两年相比，该地点就诊人数减少了 17.5%和 15.6%。与 2018 年相比，2020 年区域就诊人数减少了 52.5%，与 2019 年相比减少了 50.9%。在“封锁”开始时受伤就诊人数最初减少（p=0.076）后，随着周数的推移，受伤人数持续增加（p<0.05），达到所有就诊人数的 44.6%峰值。随着限制的放宽，受伤最常见的地点转移到了家庭以外的区域（p<0.000）。伤害类型、最终处置和与器械相关的伤害发生了显著变化（p<0.05）。在重新开放阶段 1，轮式娱乐器械与超过 20%的所有伤害有关。
本研究表明，在封锁的初始阶段，总就诊人数和总伤害人数减少。随后，受伤人数显著增加，达到所有就诊人数的 44.6%峰值。我们确定了儿科创伤的一些潜在可改变特征，未来的公共卫生策略可以针对这些特征进行干预。
