Clinical Innovations in the Department of Pediatrics
Trauma Centre at the Montreal Children's Hospital
Trauma is a leading cause of death and disability in children and teens. Trauma by its very nature is often sudden, life altering, and devastating. Rapid access to medical, surgical, nursing, rehabilitation and psychosocial trauma care, state of the art equipment, and a mature, efficient, innovative trauma care system is paramount in increasing the chances of a positive outcome for the patient and family. At the MCH the approach to trauma care is interprofessional and involves the interplay and close collaboration of 30 departments and services. Trauma impacts not only on the patient and their family, friends, and community. Our approach encourages everyone to work together to meet the multi-faceted, complex needs of the children, teens as well as their families. This practice takes place from the patient’s initial arrival in the ER through the critical care phases, early rehabilitation and recovery stages and eventual transfer to an appropriate Rehabilitation Centre, community resource or return home with comprehensive coordinated follow up.
Every year, more than 16,000 children and teens are treated in our Emergency Department for a large variety and severity of traumatic injuries. Annually, 300-350 patients sustain moderate to severe injuries requiring hospitalization and the timely interventions of our many trauma specialists. We take great pride in being a supra-regional provincially designated Tertiary Care Level Trauma Centre and a Neurotrauma Centre of Expertise, and in the 5 inter-professional clinical programs that we have developed over the past 25 years, namely: Neurotrauma; Trauma; Burn Trauma; Mild Traumatic Brain Injury; and Trauma Team Leader. Through the many teams of trauma experts involved in these different programs, we provide comprehensive, individualized, specialized care. All programs are closely linked to our Trauma Education and Research Program. Additionally, our Injury Prevention Program, acknowledged for it’s leadership and knowledge sharing is intricately involved in public awareness, education, and advocacy. Our Trauma Centre enjoys a collaborative, professional relationship with the local and national media, and along with being closely affiliated with the Canadian Hospitals Injury Reporting and Prevention Program facilitates the diffusion and provision of timely expertise and alerts.
In Canada, one of the leading causes of death due to unintentional injury is motor vehicle collisions (PHAC, 2013). Compared to all other ages, youth aged 16-24 have a higher risk of dying in a car crash per kilometer driven (Transport Canada, 2011). In 2017, the death toll in the 15-24 year old age group increased by 63% compared to 2016 and this is expected to continue to rise with the legalization of marijuana (SAAQ, 2018).
Is the Thrill Worth It? is a 2-part interactive program developed by the Montreal Children’s Hospital Trauma Centre’s Injury Prevention Program targeting secondary IV and V students.
Part 1: Student Leadership in Injury Prevention Program (SLIPP) team is formed within each of the participating schools tasked to create a year-long awareness campaign on assorted important road safety topics.
Part 2: An interactive presentation for senior students given by Trauma Centre staff. The presentation focuses on risk factors associated with car crashes, strategies to manage challenging situations, and the implications of alcohol and cannabis abuse.
The 2-part nature of the Program allows the students to not only learn about risks related to driving, but also to take ownership of the message, which is consistently reinforced through different creative initiatives throughout the school year. By using peer leaders and having the messages conveyed in an ongoing manner, the Is the Thrill Worth It? Program has the potential to create a larger social change within individual school communities and impact the road safety behaviours of the students.
Is the Thrill Worth It? is designed to expose students to risk factors and encourage them to make informed choices with regards to responsible driving. The specific topics covered in this program include:
a. Distracted driving
b. Impaired driving
f. Adolescents and cannabis-use
g. Alcohol intoxication
Is the Thrill Worth It? aims to promote student confidence and resilience in dealing with risky behaviours. The Program is designed to promote reflection and critical thinking while encouraging the students to develop concrete strategies to deal with challenging driving scenarios, ultimately making them better prepared to cope.
For more information on the program and how to participate contact liane.fransblow [at] muhc.mcgill.ca (Liane Fransblow) or angeliki.souranis [at] muhc.mcgill.ca (Angeliki Souranis)
The Montreal Children’s Hospital Trauma Centre offers a variety of educational resources for patients, families, clinicians, teachers, educators, coaches, sporting organizations, community organizations and media regarding a range of trauma topics covering all ages from 0-18. Additionally, monthly social media posts are disseminated through the Montreal Children’s Hospital Facebook and Instagram Pages with timely and important prevention messages. Feel free to follow the page and share the posts.
- Please don’t Shake your baby (English version): https://www.thechildren.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/02e-please-don-t-shake-your-baby_1_0.pdf
- Pour L'amour! Ne secouez pas votre bébé https://www.hopitalpourenfants.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/02f-pour-l-amour-ne-secouez-pas-votre-bebe.pdf
- Road Safety : https://www.thechildren.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/32a-roadsafety_0.pdf
- La sécurité routière https://www.hopitalpourenfants.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/32f-la-securite-routiere.pdf
- Scald burns : https://www.thechildren.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/13e_scaldburns_0.pdf
- Les brûlures: https://www.hopitalpourenfants.com/sites/default/files/PDFs/Trauma/Current_Brocheurs/13f_brulures.pdf
- Helmet : https://www.thechildren.com/sites/default/files/24-wear-a-helmet.pdf
- Casque: https://www.hopitalpourenfants.com/sites/default/files/24-porte-un-casque.pdf
- Infant Toddler : https://www.thechildren.com/sites/default/files/19094-04e_infants-toddlers_epr3.pdf
- Bébés et bambins: https://www.hopitalpourenfants.com/sites/default/files/19094-04f_infants-toddlers_epr3.pdf
- Water Safety (bilingual) :
In 2020 concussions are identified as a health issue of significant societal concern. As such, they are of great interest to the medical, sports, educational, and scientific communities. The Montreal Children’s Hospital developed the first Pediatric and Adolescent Neurotrauma Program in Quebec and Canada in 1989. In the late 90’s we became pioneers in the field of Concussion acknowledging the important issues in youth pertaining to this new field of TBI. Our innovative inter-professional Concussion Clinic has been recognized as a model for care since its development in 2007. Over the past 25 years Trauma Specialists at the Montreal Children’s Hospital Trauma Centre, McGill University Health Centre have been leaders in this area, developing and implementing an innovative, comprehensive, proactive, inter-professional approach to the management of concussions in youth. The approach to care is in keeping with the most recent evidence and based on extensive clinical expertise. Additionally our clinical and research arms of our program are closely linked as is our knowledge diffusion, and primary, secondary, and tertiary prevention strategies. In our Mild Traumatic Brain Injury Program with its Inter-professional Concussion Clinic we combine our trauma knowledge and expertise with injury prevention strategies, and apply it to the composite life of a child or teen at school, play, and at home.
The team consists of Trauma Coordinators, Administrative Coordinator, Physiotherapists, Psychologists, Neuropsychologists, Physician Consultants (i.e. ED, Neurology, ENT, Neurosurgery, Ophthalmology, and others), a Clinician Research Scientist, research assistants, and other rehabilitation and psychosocial consultants as needed for the specific patient and family. Over 900 patients are referred annually from our Emergency Department, Regional Centres, Adult Trauma Centres, and Community Physicians. There are>4000 patient visits annually with an emphasis on providing early proactive intervention, expert guidance, activity management, return to school and return to sport & other activity recommendations, guidance for teachers, coaches, and parents.
For more information about the innovative concussion kit and how to refer a patient to our clinic see our website: www.thechildren.com/concussions
The MCH Trauma Centre took a national and provincial leadership role in alerting the public to the risks of ingestion of edible cannabis in children following an increase in the number of cases treated in our Centre. Subsequently, the Quebec Ministry of Health responded by banning the production and sale of cannabis edibles that are enticing to children. A priority of this media campaign by our Trauma Centre was to educate the public that legalization of cannabis does not make for safe consumption by children. Recommendations were provided.
Cannabis information for Teenagers: https://www.thechildren.com/sites/default/files/PDFs/Trauma/cannabis_brochure_teenagers_final_eng-fr.pdf
Cannabis information for parents and caregivers of young children: https://www.thechildren.com/sites/default/files/PDFs/Trauma/cannabis_brochure_parents_final_eng-fr.pdf
Complex Care at Home For Children Website
The "Complex Care At Home For Children" website was designed to to compliment the direct teaching between healthcare professionals and family caregivers as well as provide a useful, electronic and printable resource to refer to once at home.
The website offers practical tips on how to prepare the child and family for care at home including: step-by-step care procedures with illustrations; everyday tips; and, frequently asked questions for the following home care needs: respiratory care; enterostomy care; parenteral nutrition; enteral nutrition; peritoneal dialysis; intravenous antibiotics; and, intermittent catheterization.
The Innovation Fund Awards are an annual opportunity to provide support for projects formulated by the Medical Service Staff Association membership targeting efforts in clinical innovation.
2020-2021 Projects Funding Requests
The deadline for MSSA memberhsip to submit their 2020-2021 project request in 8:00 a.m. on January 20, 2020. For more information please see the MSSA Innovation Fund Request Form.
2019-2020 Project Recipients
Dr. Holly Agostino
Safe Spaces Improving the Delivery of Adolescent Confidential Care in a Tertiary Care Setting
Dr. Brett Burstein
Derivation of a novel clinical prediction rule for febrile young infants incorporating procalcitonin testing: A multi-center feasibility study
Dr. Sara Long-Gagné and Dr. Hema Patel
Validation of a new needs-based stratification tool for attribution of health care services in children with medical complexity
Dr. Francois Olivier
Enhancement of Discharge Summary Quality Across the MCH
Dr. Jesse Papenburg
Pilot implementation of a highly multiplexed rapid meningoencephalitis panel for cerebrospinal fluid testing at the Montreal Children’s Hospital: feasibility, clinical impact and cost-effectiveness
Dr. Anne Marie Sbrocchi
Changing the learning lens: Evaluation of the impact of a home visit on pediatric postgraduate trainee perceptions of children with medical complexity and their families
2018-2019 Project Recipients
Dr. Moshe Ben-Shoshan
Anaphylaxis in the Emergency Room: Are we treating it poorly?
Dr. Tanya Di Genova
Quality Improvement Initiative: Implementation of a Surge and Overcapacity Plan at the Montreal Children’s Hospital
Dr. Patricia Fontela
Reducing Unnecessary Antibiotics in Critically Ill Infants with Viral Bronchitis
Dr. Patricia Li
Transforming care for the most vulnerable children: piloting and evaluating a Newcomer Navigator for the Montreal Children’s Hospital Multicultural Clinic
Dr. Pramod Puligandla
Congenital Diaphragmatic Hernia Collaborative: Strategy for the Implementation of Evidence and Consensus-Based Clinical Management Guidelines
Dr. Samara Zavalkoff
PAD your ICU (Phase Two)