Children with multiple injuries.

Abstract

Injury or trauma is the greatest threat in childhood and leading cause of pediatric death. However, the child with multiple injuries may or may not be life threatened, and a team of specialists, with members representing pediatric trauma surgery, neurosurgery, orthopedic surgery, pediatric emergency care, pediatric critical care, may not be immediately available. If the patient9s primary pediatrician or pediatric emergency or critical care specialist must provide stabilization because a multidisciplinary team of specialists is not immediately available, then an organized approach to initial assessment, stabilization, and establishment of priorities for definitive care is necessary to ensure optimal outcome. Pediatricians and pediatric specialists need to work together to enhance our health care delivery system and improve its capability in delivery of optimal care for the injured child, particularly the child with multiple injuries. Key ingredients of an emergency medical services for children (EMS-C) system include: (1) counseling of patients and/or families by pediatricians concerning regional access to emergency medical services; (2) assuring universal availability of a method of emergency medical services access, whether by strategically placed emergency public telephones, residential telephones, shortwave radios, the 911 system, VHF or UHF communications, or other; (3) establishing regional on-line medical control by attending physician specialists 24 hours a day to supervise care of the child from the moment of injury until asurance of definitive care;