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The injured child. An approach to care
M L Moront1, J A Williams, M R Eichelberger
1Department of Emergency Trauma Services, Children's National Medical Center, Washington, DC.
Insights
Childhood injury remains a critical public health issue, necessitating a comprehensive national prevention program. Optimal care for injured children requires specialized pediatric trauma teams and a continuum of care from prevention through rehabilitation.
Area of Science:
- Public Health
- Pediatric Trauma Care
Background:
- Injury is the leading cause of death and disability in children.
- Current prevention strategies have proven insufficient.
Purpose of the Study:
- To highlight the critical need for a comprehensive national injury prevention program.
- To outline essential components for optimal care of injured children.
Main Methods:
- Review of current injury statistics and established pediatric trauma care protocols.
- Emphasis on the continuum of care from prevention to rehabilitation.
Main Results:
- Existing prevention strategies have failed to curb childhood injury rates.
- Optimal care necessitates skilled pediatric trauma assessment, rapid evacuation to specialized centers, and multidisciplinary teams.
Conclusions:
- A comprehensive national injury prevention program is urgently required.
- Effective pediatric trauma care involves specialized teams and a continuum of care, including prevention, acute treatment, and rehabilitation.
Abstract:
Injury is the leading cause of childhood death and disability in this country and has been for over a decade. Examination of the current injury statistics clearly demonstrates the failure of our present prevention strategies. Unless definitive steps are undertaken to initiate a comprehensive national injury prevention program, this tragic impact upon children will continue. To ensure that optimal care for injured children is provided, several criteria must be met. Seriously injured children require skillful assessment by clinicians experienced in pediatric trauma and rapid evacuation to a regional pediatric trauma center when appropriate. Their care is best provided by a multidisciplinary team including intensivists, surgeons, and rehabilitation specialists, all thoroughly familiar with the types of injuries children sustain. In the ICU, careful monitoring of circulatory, respiratory, renal, and neurologic status combined with early intervention for physiologic derangements maximizes the injured child's chances for recovery. Finally, it is important to understand that care for the injured child spans a continuum beginning with prevention, continuing through acute care, and ending only after rehabilitation and reintegration into the community is complete, and that each component is no less important than another. Only through these efforts can the loss of our nation's most precious resource be avoided.