Pediatric Trauma Care: An Ongoing Evolution

Trauma remains the leading cause of death and disability in children despite considerable advances in the treatment of injury in the pediatric population. As we move forward into the 21st century, the challenge will be to develop and implement appropriate triage systems to ensure that severely injured children will be treated at centers with a commitment to their care. Issues of overtriage and undertriage need to be addressed, so that the limited resource of PTCs is not overwhelmed by less severely injured patients or conversely, that the definitive management of severe injuries is not delayed by lengthy periods of evaluation at centers ill equipped to care for injured children. PTCs need to take the lead in the development of such integrated pediatric trauma systems. Finally, the importance of injury prevention strategies needs to be emphasized. The vast majority of injuries in children are potentially preventable. Institutions and individuals with a commitment to the care of those injured must also work toward the prevention of the problem in the first place through a combination of research, education, and advocacy. As those who work in the trauma field know, injury is no accident.