1. Using VPS Outside the Walls of the PICU

2. Kosair Children’s Hospital 267 bed hospital which serves as the primary pediatric teaching facility for the University of Louisville School of Medicine Level 1 Trauma designation 26 bed PICU Magnet hospital PICU is a Silver Beacon unit VPS participant since 2001 2200 admissions per year

3. Original Objectives 2001 Educate health care providers Educate the general public Educate the judicial and legislative branches of the government

4. TEN-4 BRUISING RULE ANY bruising of the TORSO EARS or NECK in a child 4 years of age or younger OR ANY bruising, ANYWHERE, on a child 4 months of age or younger Pierce et al. Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma. Pediatrics. December 2009.

5. House Bill 250 Education of all nurses, day care providers, CPS workers, EMS personnel and others about Pediatric Abusive head trauma. Norton Healthcare birthing centers were to start mandatory education concerning “crying babies” and “shaking babies” It was passed (barely) and signed into law.

6. Commitment Statement Reserve:

8. 2014JANFEB MARAPRMAYJUNJULAUGSEPOCTNOVDEC2014 Totals # TRAUMA PATIENTS153 23132217 1624136184 # INFECTIONS11 05000000018 Delay in diagnosis10 00100010003 # VENTILATED PATIENTS41 255322223132 # VENT DAYS12.71.25 10.7519.5274.5182.42.21420.2174 # EXTUBATIONS W/IN 24 HRS20 1140001130.0013 # REINTUBATIONS W/IN 24 HRS00 20010000003 # UNPLANNED EXTBATIONS00 00000000000 # DVT00 01010000002 MLS IN DAYS546.7 369635783552364439.337549 AVERAGE PIM 2 MORTALITY SCORE-4.3-4 -4.4-4.2-4 -4.5 -4.2-4.3-4.28 ACTUAL MORTALITY RATE0% 4%0% 6%0% 1% # NAT30 252025232026 # NAT DEATHS00 00001000001 Transport run sheet in EMR112 21269966 8184 Total # of Transports143 1321112016171423156173

9. Partnership to Eliminate Child Abuse Partners throughout Kentucky and Indiana Consistent messaging Dissemination of Information Education and Awareness

10. Child Fatality and Near Fatality External Review Panel 2013 is the first annual report The General Assembly enacted KRS 620.055 which created this panel and it was signed into law by Governor Steven Beshear in our lobby

11. IMPACT I nformed M others P revent A bused C hildren T oday…Tomorrow…Together

12. PICU Non-Accidental Trauma 2002-2014

13. TEN-4 Bruising Rule Patients are being seen earlier due recognition of bruising as a early sign of physical abuse Interventions and care contracts are making a difference. Prospective study that is funded by National Institute of Health

14. Health Care Provider House Bill 157 passed into law for all healthcare providers who see children are required to take CME for Pediatric Abusive Head Trauma Science of bruising Monthly abusive head trauma conference Residents rotate with Pediatric Forensics TEN 4 pocket card was developed by residents

16. 2015 Public Education Hope for Tomorrow video to all Birthing Centers in Kentucky Price is right Spanish version is coming Commitment statement after viewing

17. Research Plans Kentucky Children’s Hospital to begin using VPS Multi center trauma study Look at areas that have initiated “Hope for Tomorrow” Look at injuries caused by unrelated caregivers

18. 2015 Kentucky is #1 in Basketball

19. Child Abuse Deaths In 2005 Kentucky was ranked #1 among the 50 states for child abuse deaths 2013 data from the Child Maltreatment Report done by the United States Department of Health and Human Services Kentucky now ranks #22