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The pattern of paediatric trauma on operations
K L Woods1, R J Russell, S Bree
1Anaesthetic Department, James Cook University Hospital Middlesbrough. woodskate@hotmail.com
Insights
British military medical facilities treated 176 children injured in Iraq and Afghanistan operations. Explosive devices were the most common cause of injury, with higher rates in Afghanistan. Paediatric trauma care requires ongoing training and logistical support.
Area of Science:
- Military Medicine
- Paediatric Trauma
- Operational Health
Background:
- British military medical facilities have treated children injured during recent operations in Iraq and Afghanistan.
- Understanding current paediatric trauma patterns is crucial for future medical care development.
Purpose of the Study:
- To examine the patterns of paediatric trauma in children treated by British medical facilities during recent military operations in Iraq and Afghanistan.
Main Methods:
- Data on paediatric trauma patients (under 16) from March 2003 to August 2009 was obtained from the Joint Theatre Trauma Registry.
- Information collected included patient demographics, theatre of operation, injury mechanism and type, trauma scores, and destination.
Main Results:
- 176 children were treated, with 83.5% from Afghanistan and 16.5% from Iraq. Overall survival was 88.6%.
- Explosive devices were the primary cause of injury (59.1%), significantly higher in Afghanistan (63.5%) than Iraq (27.6%).
- Males constituted 66.5% of admissions, with the 6-8 year age group being most common. Injury Severity Scores indicated a mix of minor and severe injuries.
Conclusions:
- Paediatric trauma treatment in deployed British medical facilities is expected to continue.
- Analysis of injury patterns informs training needs and logistical requirements for paediatric care.
- Adaptations in data collection are necessary to meet the specific needs of paediatric patients, an ongoing effort by Defence Medical Services.
Objectives:
Recent military campaigns in Iraq and Afghanistan have resulted in the treatment of children in British Medical facilities. In order to determine how care for children may develop in the future, it is necessary to understand the current situation. The aim of this article is to examine the pattern of paediatric trauma on recent operations in Iraq and Afghanistan.
Methods:
Data was requested from the Joint Theatre Trauma Registry, held at the Royal Centre for Defence Medicine in Birmingham, on all trauma calls for patients aged under 16 between the dates 21/3/03 and 31/8/09. Data included age, gender, theatre of operation, injury mechanism and type, trauma scores and destination of the child.
Results:
176 children were identified with 16.5% from Iraq and 83.5% from Afghanistan. The overall survival rate was 88.6% with survival rates in Iraq of 89.7% and in Afghanistan of 88.4%. Males accounted for 66.5% of admissions and the commonest age group was age 6-8 years. In 59.1% of total admissions the mechanism of injury was related to explosives. This differed between theatres with explosive injury causing 27.6% of admissions in Iraq and 63.5% in Afghanistan. Injury Severity Scores (ISS) showed equal numbers of minor and severe injuries with fewer moderately injured patients. The median ISS of all data was nine. The median ISS from Iraq was 16 and the median ISS from Afghanistan was nine.
Conclusions:
The treatment of children in British medical facilities whilst deployed on operations is likely to continue. An assessment of the injury patterns of paediatric patients on current deployments allows development of training and an understanding of logistic requirements. Data collection will also need to be adapted to meet the needs of paediatric patients. These remain issues that are being addressed by the Defence Medical Services.
