The AAP stated public health and trauma care should address "needs of injured children across the continuum of care."
In a new technical report and revised policy statement from the American Academy of Pediatrics (AAP), the agency described key aspects to approaching trauma care systems that provide optimal care for the child under a number of circumstances, calling for optimization across the continuum of care for injured children.1
According to a press release from the AAP, the updated policy outlines the nuances of child abuse identification and reporting, as well as injury trend epidemiology, disparities in care, and advocacy and research importance.
The AAP, which is made up of over 67,000 pediatricians, noted that trauma centers, critical to saving the lives of injured children, do not always have processes and structures that are optimal across local, regional, and national levels. As injury is the leading cause of death and a frequent cause of disability in children, a system-based approach to caring for this population entails structure and function that act in an interrelated and cohesive manner in efforts to lead to improved care, noted the policy authors.
According to the AAP, the ideal trauma center provides "equitable care for all injured children, injury prevention strategies, field triage and interfacility transport, evidence-based protocols for management across the continuum of care, mental health screening during the acute phase of care and follow-up, appropriate rehabilitation and reintegration, and pediatric readiness in emergency medical services (EMS), urgent care centers and emergency departments (EDs) across the nation."
As a result, the policy authors call on every state or region to identify their respective specialized trauma centers with the resources to care for injured children, to establish a system to "triage injured children appropriately based on their needs." Additionally, the policy seeks state and federal institutions' support for pediatric trauma system development and maintenance, disaster planning, data collection and sharing, research, and education.
The policy includes sections on the following topics2:
The authors of the AAP policy suggest that pediatricians and their respective health care systems collaborate with nonmedical community members to develop and introduce programming to reduce the rate of pediatric injuries. These programs could address safety technology, legislation, or anticipatory guidance and education of caregivers. Further, prehospital and hospital clinicians should "make every effort to stay current in the management of injured children," wrote the policy authors. Part of the optimal recovery after injury includes a trauma-informed approach such as the support of mental health needs for the injured child and their families via screening and provision of available and appropriate resources.1
As previously stated, one recommendation is addressing the needs of children across the continuum of care. This includes2:
Other recommendations state that EDs throughout the United States should refer to pediatric readiness guidelines for appropriate care, that evaluation and management begin with EMS clinicians in the field and in urgent care centers, and that specialized trauma centers be essential components of trauma systems, and should provide "support and guidance to nonpediatric and nontrauma centers as part of their outreach mission."
Overall, the policy authors, led by Katherine T. Flynn-O'Brien, MD, MPH, FAAP, FACS, concluded that the "ideal pediatric trauma system is comprehensive and cohesive providing optimal and equitable care for the 'right child, at the right place, at the right time' across the care continuum."
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