Presenter Status
Fellow
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Dr. Shawn St. Peter
Presentation Type
Oral Presentation
Start Date
15-5-2026 12:15 PM
End Date
15-5-2026 12:30 PM
Abstract Text
Background: Current guidelines for discharging pediatric patients with stable solid organ injury (SOI) managed non-operatively include normal hemodynamics, successful oral intake trial, and return to non-strenuous activity. There is currently no established standard of care for patients with stable isolated grade SOI to be discharged directly from the emergency department (ED).
Objectives/Goal: The goal of this project was to validate the safety of our institutional protocol of discharging patients with stable low-grade SOIs directly from the ED after a period of observation.
Methods/Design: A retrospective analysis of a prospective observational study was conducted at a Level 1 pediatric trauma center from 2019 to 2025. Inclusion criteria were patients < 18 years old with grades I-III blunt traumatic SOI (liver, spleen, kidney, pancreas). Exclusion criteria include patients who underwent treatment at an outside hospital prior to transfer to our facility, blood transfusion requirement, angioembolization, and operative management for major intra-abdominal injury. Primary outcome was discharge from the ED. Secondary outcome was 90-day return to the ED and re-admission.
Results: 178 children met inclusion criteria. Of these, 36 (20%) with grade I-III stable SOI were discharged from the ED after a period of observation with normal hemodynamics. AAST grade I accounted for 10 (28%), grade II 20 (56%), and grade III 6 (17%) that were discharged from the ED. Mean LOS was 5.5 hours. Three patients (8%) of the ED discharges re-presented to the ED. None required intervention, re-admission or had major complications.
Conclusions: Children with isolated AAST grade I-III SOIs with normal hemodynamics after a blunt trauma can be safely discharged directly from the ED after a period of observation. Only a small number of patients returned to the ED and none of them required intervention or re-admissions.
Discharging stable isolated blunt solid organ injuries from the emergency department – a tertiary center study
Background: Current guidelines for discharging pediatric patients with stable solid organ injury (SOI) managed non-operatively include normal hemodynamics, successful oral intake trial, and return to non-strenuous activity. There is currently no established standard of care for patients with stable isolated grade SOI to be discharged directly from the emergency department (ED).
Objectives/Goal: The goal of this project was to validate the safety of our institutional protocol of discharging patients with stable low-grade SOIs directly from the ED after a period of observation.
Methods/Design: A retrospective analysis of a prospective observational study was conducted at a Level 1 pediatric trauma center from 2019 to 2025. Inclusion criteria were patients < 18 years old with grades I-III blunt traumatic SOI (liver, spleen, kidney, pancreas). Exclusion criteria include patients who underwent treatment at an outside hospital prior to transfer to our facility, blood transfusion requirement, angioembolization, and operative management for major intra-abdominal injury. Primary outcome was discharge from the ED. Secondary outcome was 90-day return to the ED and re-admission.
Results: 178 children met inclusion criteria. Of these, 36 (20%) with grade I-III stable SOI were discharged from the ED after a period of observation with normal hemodynamics. AAST grade I accounted for 10 (28%), grade II 20 (56%), and grade III 6 (17%) that were discharged from the ED. Mean LOS was 5.5 hours. Three patients (8%) of the ED discharges re-presented to the ED. None required intervention, re-admission or had major complications.
Conclusions: Children with isolated AAST grade I-III SOIs with normal hemodynamics after a blunt trauma can be safely discharged directly from the ED after a period of observation. Only a small number of patients returned to the ED and none of them required intervention or re-admissions.
