Why obtain arterial blood gases, chest x-rays, and clotting studies in injured children? Experience in a regional trauma center.

We conducted a retrospective study to determine the frequency with which arterial blood gases, chest x-rays, and blood clotting studies are obtained while caring for pediatric trauma victims in a regional trauma center, and if the clinician can predict which studies may be abnormal. Arterial blood gases were obtained in 35% of pediatric trauma victims, chest x-rays in 48%, and clotting studies in 56%. We found that abnormalities in arterial blood gases were correlated with closed head injury, intubation in the field, and sex of the patient, while abnormalities on chest x-ray correlated with closed head trauma and intubation in the field. Abnormalities in clotting studies correlated only with intubation in the field. Obtaining a chest x-ray on a pediatric trauma victim with an Injury Severity Score of less than 10 will yield little information. The utility of routine laboratory tests in pediatric trauma victims may vary significantly from that of laboratory tests in adult trauma victims.