{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:46:14Z","timestamp":1777927574545,"version":"3.51.4"},"reference-count":52,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:p>\n                    Outcomes following pediatric traumatic brain injury (TBI) are dependent on initial injury severity and prevention of secondary injury. Hypoxia, hypotension, and hyperventilation following TBI are associated with increased mortality. The purpose of this study was to determine the association of non-routine events (NREs) during the initial resuscitation phase with these physiological disturbances. We conducted a video review of pediatric trauma resuscitations of patients with suspected TBI and Glasgow Coma Scale (GCS) scores &lt;13. NREs were rated as \u201cmomentary\u201d if task progression was delayed by &lt;1\u2009min and \u201cmoderate\u201d if delayed by &gt;1\u2009min. Vital sign monitor data were used to identify periods of significant physiological disturbances. We calculated the association between the rate of overall and moderate NREs per case and the proportion of cases with abnormal vital signs using multi-variate linear regression, controlling for GCS score and need for intubation. Among 26 resuscitations, 604 NREs were identified with a median of 23 (interquartile range [IQR] 17\u201327.8, range 5\u201344) per case. Moderate delay NREs occurred in 19 resuscitations (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200932, median 1 NRE\/resuscitation, IQR 0.3\u20131, range 0\u20135). Oxygen desaturation and respiratory depression were associated with a greater rate of moderate NREs (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.008,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001, respectively). We observed no association between duration of hypotension, desaturation, and respiratory depression and overall NRE rate. NREs are common in the initial resuscitation of children with moderate to severe TBI. Episodes of hypoxia and respiratory depression are associated with NREs that cause a moderate delay in task progression. Conformance with resuscitation guidelines is needed to prevent physiological events associated with adverse outcomes following pediatric TBI.\n                  <\/jats:p>","DOI":"10.1089\/neur.2020.0043","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T16:09:36Z","timestamp":1611936576000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of Non-Routine Events and Significant Physiological Disturbances during Emergency Department Evaluation after Pediatric Head Trauma"],"prefix":"10.1177","volume":"2","author":[{"given":"Emily C.","family":"Alberto","sequence":"first","affiliation":[{"name":"Division of Trauma and Burn Surgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison R.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Amberson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arunachalam A.","family":"Thenappan","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chima","family":"Oluigbo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Marsic","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Rutgers University, Piscataway, New Jersey, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Sarcevic","sequence":"additional","affiliation":[{"name":"College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen J.","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall S.","family":"Burd","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Children's National Hospital, Washington DC, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Faul M. Xu L. Wald M.M. and Coronado V.G. (2010 March). Traumatic brain injury in the United States: emergency department visits hospitalizations and deaths 2002\u20132006. https:\/\/stacks.cdc.gov\/view\/cdc\/5571 (Last accessed May11 2020)."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3979"},{"issue":"1999","key":"e_1_3_4_4_2","first-page":"93","article-title":"Traumatic brain injury mortality among U.S","author":"Cheng P.","year":"2020","unstructured":"Cheng P., , Li R., , Schwebel D., , Zhu M., , and Hu G. (2020). Traumatic brain injury mortality among U.S. children and adolescents ages 0\u201319, years, 1999\u20132017. J. 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