Study: 1 in 4 children with major trauma do not receive care in pediatric trauma centers

New research shows that 1 in 4 children with major traumatic injury do not receive care in a pediatric trauma center, where outcomes are generally better than in adult centers. The authors of the study, published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250625, recommend evidence-based strategies to improve care for this vulnerable age group.

"Given the strong evidence of improved clinical outcomes associated with care in pediatric trauma centers, access to these centers in Canada must be improved urgently," writes Dr. Lynne Moore, professor, Department of Social and Preventive Medicine, Université Laval, Québec, Quebec, with coauthors. "Since most severely injured children first present to nonpediatric hospitals, the most effective strategies lie in strengthening decision support in prehospital environments and nonpediatric hospitals, not in costly new infrastructure."

Researchers found that in a study across 9 Canadian provinces over 5 years (2016 to 2021), 3007 children were admitted to an acute care hospital with major traumatic injuries. Of these, 2335 (77%) were directly transported (879, 29%) or transferred (1456, 48%) to a pediatric trauma center.

Pediatric trauma centers offer specialized health care and support for the specific physical and psychological needs of children and their families.

Variability in access to pediatric trauma centers exists, with higher access in Alberta and Manitoba than in Ontario, and lower access in British Columbia, Saskatchewan, and the Atlantic provinces.

The authors suggest that provincial trauma systems integrate evidence-based strategies to improve access to pediatric care. A standardized prehospital triage tool adapted to pediatric patients, pediatric readiness assessments for nonpediatric hospitals, and teleconsultation pathways between referring hospitals and pediatric centers are some strategies.

"Immediate implementation of evidence-based strategies to improve care for children with major trauma, coupled with targeted research and national data coordination, would save lives and provide more equitable trauma care for children in Canada, regardless of where they live," the authors conclude.