Improving survival through pediatric readiness at trauma centers

  • Published October 31, 2023

New research presented at the American College of Surgeons (ACS) Clinical Congress 2023 shows children treated at trauma centers that are well-prepared for pediatric care have a better chance of survival.

“What happens in that first hour after injury really impacts whether you survive, so rapid access to trauma center care for kids is important,” Aaron Jensen, MD, MEd, FACS, FAAP, principal investigator, told ACS. “But most children in the United States receive initial trauma care at non-pediatric centers because they are more readily available.”

Jensen is the trauma co-lead at the EMSC Innovation and Improvement Center (EIIC) and a surgeon at the University of California, San Francisco (UCSF). The research team included experts from EIIC and ACS. The study's lead author, Caroline Melhado, MD, MS, an EMSC trauma fellow and general surgery resident at UCSF, presented the paper at the ACS Clinical Congress.

In the study, researchers worked to find the minimum level of pediatric readiness that lowers the risk of patient death. They used data from the 2021 assessment by the National Pediatric Readiness Project (NPRP). The NPRP aims to ensure that all emergency departments (EDs) in the United States can provide high-quality care to children.

The study included 790 trauma centers in the United States, most of them not pediatric-specific trauma centers. The researchers found that centers in the top 25% of readiness – scoring over 93 out of 100 points on the NPRP assessment – had 17-27% lower odds of death than others.

The study found common issues in lower-scoring centers, like not having a pediatric emergency care coordinator, a pediatric quality improvement plan, or a pediatric disaster plan.

Jensen emphasizes that high pediatric readiness is achievable for all trauma centers and EDs.

“The goal of pediatric readiness is not to transform every ED into a pediatric trauma center,” said Jensen. “Rather, the goal is to help EDs optimize the initial care for pediatric trauma patients.”

Read the full study in the Annals of Surgery. (Note: requires subscription.)