6 Ways to Improve Trauma Care for Children


Trauma systems in the U.S. have developed dramatically in recent decades. But according to Barbara Gaines, MD, many aspects of trauma care today are designed primarily for adults. “We have built an active trauma system that works really well,” Dr. Gaines said. “But it is not always clear where children fit into the system.”

Dr. Gaines is trauma director at Children’s Hospital of Pittsburgh of UPMC, a state-designated Level I pediatric trauma center. She is also president of the recently formed Pediatric Trauma Society, which is holding its first annual meeting this month in Chicago.

“Although we have pediatric trauma centers, there is a lot of variation in access to care,” Dr. Gaines said. “In fact, the majority of injured children receive treatment in adult trauma centers or non-trauma centers.” Dr. Gaines talked recently about what all hospitals can do to improve care for injured children.

1. Don’t treat children like little adults
“Children’s injuries are a little different from adult injuries, and their response to injury is a little different,” Dr. Gaines said. Children are more likely than most adults to be injured in a fall. Low-velocity sports injuries are also more common, and children are rarely victims of violent crime. “The exception is child abuse,” Dr. Gaines said. “The constellation of injuries that an abused child suffers is very different from what we see in adult trauma.”

Unfortunately, injured children are often treated according to protocols derived from adult trauma care. “Some of these protocols are applicable to children, but we need to make sure kids are being treated as kids with pediatric-specific protocols,” Dr. Gaines said. “In some respects, we try to do less. Injured children do not necessarily need all the interventions that adults do.”

For example, approximately 95% of spleen injuries in children… (click below to continue)

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