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Observations of a pediatric surgeon in the Persian Gulf War
1Department of Surgery, William Beaumont Army Medical Center, El Paso, TX 79920-5001.
Insights
During the Persian Gulf War, pediatric trauma care was provided to noncombatant children. No child died from trauma, but complications from dehydration and malnutrition caused deaths in infants.
Area of Science:
- Pediatric Trauma Care
- Military Medicine
- Global Health
Background:
- Infectious disease is a major cause of childhood mortality in developing nations.
- The Persian Gulf War shifted the leading cause of childhood death to trauma.
- This review examines pediatric trauma care delivery in a military hospital setting.
Observation:
- The 410th Evacuation Hospital admitted 50 pediatric patients between January and April 1991.
- Of these, 40 were admitted for trauma, with a mean age of 9 years.
- Pediatric trauma mechanisms included penetrating injuries (shrapnel, gunshot), burns, motor vehicle accidents, crush injuries, and falls.
Findings:
- The overall pediatric mortality rate was 12%.
- Critically, no child died directly from traumatic injury.
- All pediatric deaths (100%) were attributed to complications of dehydration or malnutrition in infants.
Implications:
- Military hospitals can effectively manage pediatric trauma cases, even in austere environments.
- The findings highlight the critical need for addressing non-trauma-related complications like dehydration and malnutrition in pediatric populations during conflicts.
- This underscores the importance of integrated care addressing both acute trauma and underlying health issues in children affected by war.
Abstract:
In Third-World countries, infectious disease is the principal cause of childhood death and disability. During the Persian Gulf War trauma became the leading cause of death in children, prompting this review of experience with the delivery of pediatric trauma care to noncombatant children at a military hospital. Eight hundred seventy-seven patients were admitted to the 410th Evacuation Hospital from January to April 1991. Fifty of the patients (6%) were children, and 40 of the 50 were admitted for trauma. The mean age of the children was 9 years. Sixty-five percent of pediatric patients sustained penetrating injuries; mechanisms of injury included shrapnel wounds, gunshot wounds, burns, motor vehicle accidents, crush injuries, and falls. The overall mortality rate for children admitted to the hospital was 12%, but no injured child died as a result of trauma. Complications of dehydration or malnutrition in infants accounted for all the deaths.
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