Texas Children’s trauma centers see increase in patients during pandemic

June 29, 2020

Since the pandemic began, fewer children than usual have visited emergency rooms. But, according to media reports, doctors across the country say they have seen a growing number of children who suffered broken bones on bikes and trampolines, accidental poisonings and other severe injuries during the widespread lockdowns.

Instead of getting injured on playgrounds or during team sports, many children are getting hurt while playing with outdoor toys and sports equipment at home. Sales of trampolines, scooters, skateboards, bicycles and inflatable pools have surged as families look for ways to keep their kids entertained — and with parents often unable to provide constant supervision because of work and other obligations, injuries have followed.

The story is no different at Texas Children’s. All three of our trauma centers have seen an increase in the number of patients seeking our care.

“It’s been really busy for sure,” said Dr. Bindi Naik-Mathuria, medical director of the Trauma Center at Texas Children’s Hospital Medical Center Campus. “We’re seeing everything from dog bites and falls to car accidents, drownings, gunshot wounds, child abuse and neglect. The effects of the pandemic and subsequent lockdowns are definitely taking a toll on families in the Greater Houston area and beyond.”

But, Naik-Mathuria said, Texas Children’s is here for those who need our care and the trauma teams at all three campuses are well equipped to handle whatever situation they encounter.

Comprehensive care

When a child comes to one of our hospitals with a traumatic injury, they are cared for by members of one of our trauma teams either at the Medical Center Campus, at Texas Children’s Hospital The Woodlands or at Texas Children’s Hospital West Campus.

The trauma centers at The Woodlands and West Campus were recently designated Level IV trauma centers by the Department of State Health Services. The trauma center at the Medical Center Campus is a Level I Trauma Center and has been designated as such since 2010.

The teams at these centers are responsible for a patient’s care throughout their journey at Texas Children’s, which can sometimes be months long. During this time, team members work with departments across the system to coordinate a patient’s care.

“The integration across our system is so important,” said Tarra Kerr, director of the trauma program at all three campuses. “We all work together to make sure our patients get the right treatment so they can return home and have the best possible outcome.”

At the Medical Center Campus, the Level I pediatric trauma center provides around-the-clock coverage to evaluate and treat the most severely injured pediatric patients. Averaging over 1,000 trauma admissions per year, teamwork is crucial in the rapid and decisive actions needed to treat traumatic injuries.

Dedicated space for trauma cases is available in the Emergency Center, our main operating room suite and inpatient units. Approximately 70 percent of all trauma cases come from within the Metro Houston area, which consists of nine counties covering more than 9,500 square miles.

Over 50 percent of the trauma patients cared for at the Medical Center Campus are transferred from other hospitals. The average time to accept a transfer is 15 minutes, well below the 30 minute threshold that is allowed by federal regulation.

The Level IV trauma centers at West Campus and in The Woodlands are capable of stabilizing any trauma patient received, handling onsite single-system orthopedic injuries and superficial lacerations. More complex cases are stabilized and then transferred to a higher level trauma center such as our Level I trauma center in the Medical Center.

The Level IV designation sends a clear signal to first responders that our community hospitals are equipped to handle such trauma patients. West Campus and The Woodlands have been caring for such patients since the hospitals opened their doors, however the designation formalizes that process and holds the centers to certain quality and process improvement standards.

“We are a solid, tri-campus trauma center,” Kerr said. “We have made a lot of progress over the years that better ensures patients receive the right care at the right place at the right time.”

Injury prevention and research

Another area of focus for Texas Children’s trauma centers is injury prevention and research. Kristen Beckworth manages this aspect of the trauma centers at all three campuses. Her team of six educators works in the hospitals and the communities that surround them.

“The goal of the Center for Childhood Injury Prevention is to address major areas of unintentional injuries to children in our local area,” Beckworth said. “This is accomplished by raising awareness among adults and children, providing lifesaving education and resources, and by making childhood injury a public priority.”

With pediatric injury being the No. 1 cause of injury and death of children in the United States, the center educates thousands of parents and children each year on a variety of child safety topics, such as child passenger safety, safe sleep, home safety and bike and pedestrian safety. The center works with trauma center registrars to determine trends, write grants, and implement programming so that what they do is evidence based and in line with what the community needs.

Valuable local partners are key to the center’s success, especially during the pandemic when Beckworth and her team are tied to their decks more than giving in-person education and working with people face to face.

“It’s been challenging, but we are doing what we can,” Beckworth said. “People have been very appreciative of our continued commitment to our program during such trying times.”

Some things Beckworth and her team have done since the pandemic is offered virtual car seat checks, partnered with Houston Apartment Association and Home Owner’s Association to distribute water safety tip sheets, and reached out to all Texas Children’s Pediatrics practices and Texas Children’s Urgent Cares to inform them about the increase in traumatic injuries and tips on how to prevent them.

In addition to injury prevention, Texas Children’s trauma centers aims to continuously evaluate and improve the quality of care given to trauma patients from the perspective of our patients, parents, providers and system. Our trauma process improvement program monitors and evaluates patient care and system performance, while ensuring implementation of a culture of safety. The team participates in the American College of Surgeons’ Trauma Quality Improvement Program and attends the annual scientific meeting and training which compares and provides benchmarking for all level I and II trauma centers.

“We have a very active research program and put a lot of protocols into place that increase the quality of care for our patients, many of whom are forever changed by their injuries and have a strong bond with the people who helped them through one of the toughest times in their lives,” Naik-Mathuria said. “I am very proud of what we and everyone involved has accomplished for the betterment of our patients and their families.”

For more information about Texas Children’s trauma centers and the teams that support them, click here. For more information about the Center for Childhood Injury and Prevention, click here.