Fall injuries in the pediatric population: Safer and most cost-effective management

Background: At our children's hospital, 30% of all trauma admissions are fr om falls. The aim of this study was to outline inefficiencies and unnecessa ry costs incurred in the care of these patients. Methods: The charts of 127 children admitted for falls (height greater than or equal to 9 feet) from 1993 to 1996 were reviewed. Patient demographics, injuries, and treatment costs were recorded and analyzed. Results: Fifty-seven children (45%) were evaluated at an outside facility b efore transfer. Of these, 73% had injuries requiring treatment at the pedia tric center. Local hospital work-up resulted in an average treatment delay of 1.5 hours. Additionally, significant cost was incurred by duplication of radiographic studies, the majority of which were normal, Conclusion: Improved and more cost-effective care in pediatric falls can he ensured by immediate transfer of patients with significant injuries, omiss ion of radiographs before transfer, and avoidance of multiple routine x-ray films, the majority of which are normal.