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AAP urges stronger, more efficient pediatric trauma management
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A policy statement recently released by the AAP’s Committee on Pediatric Emergency Medicine and other groups recommended a series of guidelines to improve trauma systems in the United States to increase the efficiency in treatment of injured children and adolescents.
“It is estimated that one in four children sustain an unintentional injury requiring medical care each year,” David W. Tuggle, MD, FAAP, FACS, committee member and associate trauma medical director at Dell Children’s Medical Center in Texas, said in a press release. “The direct cost of childhood injury is greater than $50 billion annually. Survivors of childhood trauma may suffer lifelong disability and require long-term skilled care. Improving outcomes for the injured child requires an approach that recognizes childhood injury as a significant public health problem.”
The guidelines recommend all regions in the United States adopt an inclusive trauma system, in which all emergency medical services providers, physicians, nurses, aides and hospitals participate in the treatment of injured children and adolescents to facilitate prompt communication. These guidelines also include earlier recognition of critical injuries and continuing education for trauma and emergency care providers. Although all hospitals may not be equipped with appropriate pediatric options to care, the AAP urged that all hospitals be prepared for pediatric emergencies.
According to the statement, every state should have a pediatric trauma center, or an ED equipped to handle severe injuries in children. An estimated 17.4 million children do not live within 60 minutes of a pediatric trauma center in less-populated states, and access to such centers or pediatric ICU beds is strongly associated with greater child injury survival rates.
In addition, pediatric critical care transport teams are an excellent resource for transferring injured children from regional referral centers to tertiary trauma facilities.
“Hospitals that seek regional or state designation or verification as a pediatric trauma center through the verification process of the [American College of Surgeons] or similar state trauma designation processes are examples of facilities that have made an extraordinary effort to provide resources to care for injured children,” Tuggle and colleagues wrote in the statement.
The AAP proposed mandatory systematic child death review processes to identify emerging trends so that prevention and intervention methods can be implemented, that pediatricians detect injury-prevention activities and pediatric pre-disaster and mass casualty planning.
“Although the needs of children in disasters can be anticipated, the capability of a trauma system to meet these needs will remain in question until the nation achieves an optimal level of emergency readiness for children on a daily basis,” Tuggle and the committee wrote. – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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