6 Ways to Improve Trauma Care for Children


For example, approximately 95% of spleen injuries in children can be managed non-operatively. That figure is only 70% in adults. “A number of studies have shown that children who present at a pediatric center are less likely to receive a splenectomy, even if you control for injury severity,” Dr. Gaines said.

Imaging protocols should also be adjusted for children. “Children who present to adult centers receive more CT scans than those who present to pediatric centers, without a difference in outcome,” Dr. Gaines said. Providers should think twice when ordering pan-scans for children with low-velocity injuries. “Just because it’s the protocol for adults, that’s probably not a reason to do it for children.”

2. Get ready for pediatric patients
Injured children require child-sized medical supplies — from blood pressure cuffs to CV catheters to spine stabilization devices. Unfortunately, most hospital EDs are not fully stocked. A 2006 study showed that only 7% of hospital emergency departments had 100% of recommended pediatric care supplies.

“There is a real push to get basic pediatric supplies on hand,” Dr. Gaines said. “The hard thing is that one size does not fit all when it comes to this population. A 3-kilo baby is really different from a 70-kilo teenager.”

3. Educate providers on pediatric trauma
The relative infrequency of pediatric trauma is an obstacle to ensuring the best care. “Because children are rarely seen in an emergency setting, many practitioners are very uncomfortable caring for them,” Dr. Gaines said. “Sometimes, just that level of discomfort makes them do things differently.”

Hospitals with low pediatric trauma volumes should provide some form of continuing medical education in pediatric injury, Dr. Gaines believes. One option is establishing partnerships between pediatric trauma centers and community hospitals.

4. Remember that child-centered care is parent-centered care
“The strong focus of pediatrics in general is to involve families in the child’s care,” Dr. Gaines said. This principle also applies to pediatric trauma care.

At Children’s Hospital of Pittsburgh, parents are allowed to be present in the trauma bay during resuscitation… (click below to continue)

1 2 3

Comments are closed.