{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:02:28Z","timestamp":1789552948932,"version":"build-2803163510"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>There is a paucity of information on pediatric traumatic brain injury (TBI) care in Asia and Latin America. In this study, the authors aimed to describe the clinical practices of emergency departments (EDs) participating in the Saline in Asia and Latin-America Neurotrauma in the Young (SALTY) study, by comparing designated trauma centers (DTCs) and nontrauma centers (NTCs) in their networks.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors performed a site survey study on pediatric TBI management in the EDs in 14 countries. Two European centers joined other participating sites in Asia and Latin America. Questions were formulated after a critical review of current TBI guidelines and published surveys. The authors performed a descriptive analysis and stratified centers based on DTC status.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of 24 responding centers (70.6%), 50.0% were DTCs, 70.8% had academic affiliations, and all centers were in urban settings. Patients were predominantly transferred to DTCs by centralized prehospital services compared to those sent to NTCs (83.3% vs 41.7%, p = 0.035). More NTCs received a majority of their patients directly from the trauma scene compared to DTCs (66.7% vs 25.0%, p = 0.041). Ten centers (41.7%) reported the use of a TBI management guideline, and 15 (62.5%) implemented CT protocols. Ten DTCs reported implementation of intervention strategies for suspected raised intracranial pressure (ICP) before conducting a CT scan, and 6 NTCs also followed this practice (83.3% vs 50.0%, p = 0.083). ED management for children with TBI was comparable between DTCs and NTCs in the following aspects: neuroimaging, airway management, ICP monitoring, fluid resuscitation, anticoagulant therapy, and serum glucose control. Hyperventilation therapy for raised ICP was used by 33.3% of sites.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This study evaluated pediatric TBI management and infrastructure among 24 centers. Limited differences in prehospital care and ED management for pediatric patients with TBI were observed between DTCs and NTCs. Both DTCs and NTCs showed variation in the implementation of current TBI management guidelines. There is an urgent need to investigate specific barriers to guideline implementation in these regions.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.1.peds22456","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T16:02:36Z","timestamp":1677859356000},"page":"598-606","source":"Crossref","is-referenced-by-count":8,"title":["Prehospital and emergency management of pediatric traumatic brain injury: a multicenter site survey"],"prefix":"10.3171","volume":"31","author":[{"given":"Gawin","family":"Mai","sequence":"first","affiliation":[{"name":"Duke-NUS Medical School, Singapore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Hau","family":"Lee","sequence":"additional","affiliation":[{"name":"Children\u2019s Intensive Care Unit, KK Women\u2019s and Children\u2019s Hospital, SingHealth Paediatrics Academic Clinical Programme, Duke-NUS Medical School, Singapore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Caporal","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Children\u2019s Hospital \"Sor Maria Ludovica,\" Buenos Aires, Argentina;"},{"name":"Pediatric Collaborative Latin American Network (LARed Network);"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Roa G.","sequence":"additional","affiliation":[{"name":"Pediatric Collaborative Latin American Network (LARed Network);"},{"name":"Pediatric Intensive Care Unit, Los Cobos Medical Center, Universidad del Bosque, Bogot\u00e1, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Gonz\u00e1lez-Dambrauskas","sequence":"additional","affiliation":[{"name":"Pediatric Collaborative Latin American Network (LARed Network);"},{"name":"Department of Pediatrics and Pediatric Intensive Care Unit, Hospital Pereira Rossell, School of Medicine, University of the Republic, Montevideo, Uruguay;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation, Singapore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Yock-Corrales","sequence":"additional","affiliation":[{"name":"Emergency Department, National Children\u2019s Hospital \"Dr. Carlos Saenz Herrera,\" CCSS, San Jos\u00e9, Costa Rica;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qalab","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Kazzaz","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Ministry of National Guards Health Affairs, Riyadh, Saudi Arabia;"},{"name":"King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianna Sri","family":"Dewi","sequence":"additional","affiliation":[{"name":"KK Research Centre, KK Women\u2019s and Children\u2019s Hospital, Singapore; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ling","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, KK Women\u2019s and Children\u2019s Hospital, SingHealth Paediatrics Academic Clinical Programme, SingHealth Emergency Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah M.","family":"Turina","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Ricardo Guti\u00e9rrez Children\u2019s Hospital, Buenos Aires, Argentina;"},{"name":"Master\u2019s Degree Higher Education for Health Professionals, University Institute School of Medicine of the Italian Hospital (IUHI), Buenos Aires, Argentina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas A.","family":"Dom\u00ednguez-Rojas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Pediatric Critical Care Medicine, Hospital Nacional Hipolito Unanue, El Agustino, Peru;"},{"name":"Pediatric Chapter of the Peruvian Society of Intensive Care Medicine, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"Pilar-Orive","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Cruses University Hospital, Barakaldo, Bizkaia, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin Seng","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Malaya, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qalab","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willmer E. 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