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. 2022 Jan 1;38(1):e349-e353.
doi: 10.1097/PEC.0000000000002279.

Pediatric Trauma Arrival Times and the Swing Shift

Patrick Berg  1 , Paul J Chestovich, Stephanie Jones, Gayle Allenback, Allison G McNickle, Syed F Saquib, Douglas R Fraser, Deborah A Kuhls
Affiliations

Pediatric Trauma Arrival Times and the Swing Shift

Patrick Berg et al. Pediatr Emerg Care. .

Abstract

Background: Trauma center staff and trainees are often assigned to a day and night shift. However, for adult trauma, the swing shift has been found to offer superior clinical exposure compared with a standard day or night shift for trainees. We characterized patterns in pediatric trauma arrival times based on the hour, weekday, and month and studied whether or not the swing shift also maximizes exposure to hands-on experiences in managing pediatric trauma.

Methods: We performed a retrospective review of the trauma database at our urban, level 2 pediatric trauma center. We identified all the pediatric trauma activations in the last 13 years (2006-2018). A retrospective shift log was created, which included day (7:00 am to 7:00 pm), night (7:00 pm to 7:00 am), and swing (noon to midnight) shifts. The shifts were compared using the Wilcoxon match-pairs signed rank test. Weekends data were also compared with weekdays, and comparisons were also made for pediatric patients with Injury Severity Scores (ISS) >15.

Results: There were 3532 pediatric patients identified for our study. The swing shift had 1.98 times more activations than the night shift, and 1.33 more than the day shift (P < 0.001). The swing shift was also superior to both the day and night shifts for exposure to patients with Injury Severity Score greater than 15 (P < 0.001). Weekend days had 1.28 times more trauma than the weekdays (P < 0.001). Peak arrival time was between the hours of 3:00 pm and 9:00 pm, and patient age did not have an effect on this trend.

Conclusions: Experience in managing pediatric trauma patients will improve for trainees who utilize the swing shift. In addition, the hours between 3:00 pm and 9:00 pm on weekends may represent a time of particularly high likelihood of pediatric trauma arrivals, which may require extra staff and hospital resources.Level of Evidence: Therapeutic Study, Level IV.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Patel MB, Guillamondegui OD, May AK, et al. Twenty-year analysis of surgical resident operative trauma experiences. J Surg Res . 2013;180:191–195.
    1. Bittner JG 4th, Hawkins ML, Medeiros RS, et al. Nonoperative management of solid organ injury diminishes surgical resident operative experience: is it time for simulation training? J Surg Res . 2010;163:179–185.
    1. Fakhry SM, Watts DD, Michetti C, et al. The resident experience on trauma: declining surgical opportunities and career incentives? Analysis of data from a large multi-institutional study. J Trauma . 2003;54:1–7.
    1. Strumwasser A, Grabo D, Inaba K, et al. Is your graduating general surgery resident qualified to take trauma call? A 15-year appraisal of the changes in general surgery education for trauma. J Trauma Acute Care Surg . 2017;82:470–480.
    1. Yaghoubian A, De Virgilio C, Destro L, et al. Optimal deployment of trauma personnel in the 80-hour work week era based on peak times of trauma patient arrival. Am Surg . 2010;76:1039–1042.

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