The American Academy of Pediatrics recently published its guidelines for how hospitals, and systems of hospitals, should care for injured children. The recommendations have also been endorsed by the relevant organizations of surgeons, emergency physicians, critical care physicians, and children’s hospitals.
Traumatic injuries in children are a huge issue. They are the number one killer of children, accounting for 60% of all deaths up to the age of 18. Thus injuries kill more children than all other causes combined. There is also a large burden of disability later in life for injured children, particularly those with traumatic brain injury. One study from a decade ago estimated this financial burden — initial medical costs, lifetime medical costs, and lost income — at nearly 100 billion dollars.
In spite of the importance of injuries to children’s health care needs, pediatric trauma systems have lagged behind those of adults. There are several reasons for this. For one thing, all the pediatric specialists needed to provide optimal care in fully-equipped PICUs are not available in many places. This is not so much of a problem for adolescents, but it is a major problem for pre-schoolers and infants. Another reason is that, from my perspective, children often seem to be off the radar of governmental and institutional planners. One clear purpose of the AAP publishing these guidelines is to try to change that.