Adult versus pediatric prehospital trauma care: is there a difference?

Management of the injured child in the prehospital setting continues to be debated. Issues raised in the literature include time spent on scene, skill maintenance and performance, and reported poorer outcomes compared with adults.

Retrospective 2-year review of all pediatric (n = 232) and adult (n = 3,375) patients treated by a single emergency medical services agency and transported and admitted to a Level I trauma center. Patients were divided into two groups, pediatric (age 0 to 12 years) and adult (age >12 years) and further stratified into three Injury Severity Score subgroups; 1 to 15, 16 to 25, and more than 25.

There were no significant differences in scene time for any of the groups. The percentage of patients with intravenous access or endotracheal intubation in the field and the mean Injury Severity Score were not different for the moderate or severely injured groups, although in the minor trauma group fewer pediatric patients had intravenous access or intubation performed. There were no differences in outcome for any of the groups.

Paramedics are able to provide pediatric trauma patients a level of care comparable to that provided adult patients with similar outcome.