BMC emergency medicine · 2025
Developing a clinical decision tool to support paramedics when assessing and managing children with minor head injury.
СтатьяНазвание и аннотация: Перевод в очереди
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Proctor Alyesha, Lyttle Mark D, Voss Sarah, Benger Jonathan
Аннотация
BACKGROUND: Head-injured children are commonly transported to the Emergency Department (ED) by ambulance. However, most of those conveyed are deemed non-serious and are discharged at triage. Hospital clinicians use clinical decision tools to support their assessment of head-injured children; however, this is generally to determine whether a computed tomography (CT) scan is indicated. Currently, there is no pre-hospital clinical decision tool designed to support paramedics when assessing and managing head-injured children at scene. The aim of this study was to determine consensus amongst experts and stakeholders to inform the development of a new tool to support paramedics in safely assessing and managing children with minor head injury.
METHODS: A consultation process using a modified online Delphi technique comprising two rounds and a consensus meeting was completed between September 2023 and January 2024. A 5-point Likert scale was used to assess consensus, set a-priori at 67%. Free text survey responses arising from the Delphi were studied and concepts were developed. Data were analysed anonymously, and feedback was given after each round.
RESULTS: An expert stakeholder group comprising 36 participants took part in Round One, and 34 participants in Round Two of the online Delphi. The participants included parents/grandparents/caregivers, paramedics, primary care clinicians, ED doctors, ED nurses and Paediatricians. Consensus was reached in 36 statements following Rounds One and Two. The remaining eight statements were discussed at a consensus meeting, which was attended by 12 stakeholders. Seven of the eight statements reached agreement.
CONCLUSION: This Delphi study has established consensus amongst a group of experts and stakeholders on the content and format of a pre-hospital paediatric head injury clinical decision tool, designed for use by paramedics: PATCH (Pre-hospital Assessment Tool for Children with Head injury). Future research should include an evaluation of the acceptability and usability of PATCH by paramedics.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: A consultation process using a modified online Delphi technique comprising two rounds and a consensus meeting was completed between September 2023 and January 2024. A 5-point Likert scale was used to assess consensus, set a-priori at 67%. Free text survey responses arising from the Delphi were studied and concepts were developed. Data were analysed anonymously, and feedback was given after each round.
RESULTS: An expert stakeholder group comprising 36 participants took part in Round One, and 34 participants in Round Two of the online Delphi. The participants included parents/grandparents/caregivers, paramedics, primary care clinicians, ED doctors, ED nurses and Paediatricians. Consensus was reached in 36 statements following Rounds One and Two. The remaining eight statements were discussed at a consensus meeting, which was attended by 12 stakeholders. Seven of the eight statements reached agreement.
CONCLUSION: This Delphi study has established consensus amongst a group of experts and stakeholders on the content and format of a pre-hospital paediatric head injury clinical decision tool, designed for use by paramedics: PATCH (Pre-hospital Assessment Tool for Children with Head injury). Future research should include an evaluation of the acceptability and usability of PATCH by paramedics.
CLINICAL TRIAL NUMBER: Not applicable.