Related Experiment Video
Updated: Aug 14, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members
Martin Reichert1, Massimo Sartelli2, Ingolf H Askevold1
1Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
Insights
Global pediatric trauma care varies significantly by hospital resources and trauma center level. Many healthcare providers lack sufficient experience and training for severe pediatric trauma cases, highlighting a critical need for specialized education.
Area of Science:
- Emergency Medicine
- Pediatric Surgery
- Trauma Surgery
Background:
- Global pediatric trauma care management remains unclear compared to adult care.
- International perspectives on the management of severely injured children are needed.
Purpose of the Study:
- To investigate the structural management of pediatric trauma in centers of varying trauma levels.
- To assess global experiences with pediatric trauma management.
Main Methods:
- A web-survey was distributed to the World Society of Emergency Surgery mailing list (10/2021-03/2022).
- The survey collected data on hospital characteristics, pediatric trauma case-loads, critical care capacities, trauma team composition, and management experiences.
- Responses were analyzed statistically, with subgroups based on hospital size.
Main Results:
- 133 participants from 34 countries responded, mostly from large hospitals (72.9%) and Level I/II trauma centers (82.0%).
- While 74.4% of hospitals offer unrestricted pediatric care, only 63.2% and 42.9% had sufficient experience with children ≤10 and ≤5 years old, respectively.
- Larger hospitals demonstrated better infrastructure, higher case-loads of severely injured children, and more multidisciplinary trauma management, yet a majority of respondents felt unprepared and called for specialized training.
Conclusions:
- Pediatric trauma care and provider experience are influenced by hospital volume, trauma center level, and infrastructure.
- A significant gap exists in pediatric trauma management knowledge across all hospital levels.
- There is a clear demand for enhanced educational and practical training in pediatric trauma care globally.
Background:
In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world.
Methods:
A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis.
Results:
A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p < 0.01). With regard to hospital size (≤ 500 versus > 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p < 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children < 12 years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p < 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively).
Conclusions:
Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management.
