Arul G S, Reynolds J, DiRusso S, Scott A, Bree S, Templeton P, Midwinter M J
UK Medical Treatment Facility, Role 3 Hospital, Camp Bastion, Afghanistan.
Ann R Coll Surg Engl. 2012 Jan;94(1):52-7. doi: 10.1308/rcsann.2012.94.1.e52.
International humanitarian law requires emergency medical support for both military personnel and civilians, including children. Here we present a detailed review of paediatric admissions with the pattern of injury and the resources they consume.
All paediatric admissions to the hospital at Camp Bastion between 1 January and 29 April 2011 were analysed prospectively. Data collected included time and date of admission, patient age and weight, mechanism of injury, extent of wounding, treatment, length of hospital stay and discharge destination.
Eighty-five children (65 boys and 17 girls, median age: 8 years, median weight: 20 kg) were admitted. In 63% of cases the indication for admission was battle related trauma and in 31% non-battle trauma. Of the blast injuries, 51% were due to improvised explosive devices. Non-battle emergencies were mainly due to domestic burns (46%) and road traffic accidents (29%). The most affected anatomical area was the extremities (44% of injuries). Over 30% of patients had critical injuries. Operative intervention was required in 74% of cases. The median time to theatre for all patients was 52 minutes; 3 patients with critical injuries went straight to theatre in a median of 7 minutes. A blood transfusion was required in 27 patients; 6 patients needed a massive transfusion. Computed tomography was performed on 62% of all trauma admissions and 40% of patients went to the intensive care unit. The mean length of stay was 2 days (range: 1-26 days) and there were 7 deaths.
Paediatric admissions make up a small but significant part of admissions to the hospital at Camp Bastion. The proportion of serious injuries is very high in comparison with admissions to a UK paediatric emergency department. The concentration of major injuries means that lessons learnt in terms of teamwork, the speed of transfer to theatre and massive transfusion protocols could be applied to UK paediatric practice.
国际人道法要求为军事人员和平民，包括儿童，提供紧急医疗支持。在此，我们对儿科住院病例的损伤模式及其所消耗的资源进行详细综述。
对2011年1月1日至4月29日期间在巴斯蒂安营地医院收治的所有儿科住院病例进行前瞻性分析。收集的数据包括入院时间和日期、患者年龄和体重、损伤机制、伤口范围、治疗情况、住院时间和出院去向。
共收治85名儿童（65名男孩和17名女孩，中位年龄：8岁，中位体重：20千克）。63%的病例入院指征为与战斗相关的创伤，31%为非战斗创伤。在爆炸伤中，51%是由简易爆炸装置所致。非战斗紧急情况主要是家庭烧伤（46%）和道路交通事故（29%）。受影响最严重的解剖部位是四肢（44%的损伤）。超过30%的患者有重伤。74%的病例需要手术干预。所有患者进入手术室的中位时间为52分钟；3名重伤患者直接进入手术室，中位时间为7分钟。27名患者需要输血；6名患者需要大量输血。62%的创伤住院患者接受了计算机断层扫描，40%的患者进入重症监护病房。平均住院时间为2天（范围：1 - 26天），有7例死亡。
儿科住院病例占巴斯蒂安营地医院住院病例的比例虽小但意义重大。与英国儿科急诊科的住院病例相比，重伤比例非常高。重伤病例集中意味着在团队协作、转送至手术室的速度和大量输血方案方面所吸取的经验教训可应用于英国儿科实践。
