Kiragu Andrew W, Dunlop Stephen J, Mwarumba Njoki, Gidado Sanusi, Adesina Adesope, Mwachiro Michael, Gbadero Daniel A, Slusher Tina M
Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, United States.
Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, MN, United States.
Front Pediatr. 2018 Jun 4;6:155. doi: 10.3389/fped.2018.00155. eCollection 2018.
Trauma constitutes a significant cause of death and disability globally. The vast majority -about 95%, of the 5.8 million deaths each year, occur in low-and-middle-income countries (LMICs) 3-6. This includes almost 1 million children. The resource-adapted introduction of trauma care protocols, regionalized care and the growth specialized centers for trauma care within each LMIC are key to improved outcomes and the lowering of trauma-related morbidity and mortality globally. Resource limitations in LMICs make it necessary to develop injury prevention strategies and optimize the use of locally available resources when injury prevention measures fail. This will lead to the achievement of the best possible outcomes for critically ill and injured children. A commitment by the governments in LMICs working alone or in collaboration with international non-governmental organizations (NGOs) to provide adequate healthcare to their citizens is also crucial to improved survival after major trauma. The increase in global conflicts also has significantly deleterious effects on children, and governments and international organizations like the United Nations have a significant role to play in reducing these. This review details the evaluation and management of traumatic injuries in pediatric patients and gives some recommendations for improvements to trauma care in LMICs.
创伤是全球范围内导致死亡和残疾的重要原因。在每年580万例死亡病例中，绝大多数（约95%）发生在低收入和中等收入国家（LMICs）3 - 6 。这其中包括近100万儿童。在每个低收入和中等收入国家因地制宜地引入创伤护理方案、区域化护理以及增加创伤护理专业中心，是改善全球创伤治疗效果以及降低创伤相关发病率和死亡率的关键。低收入和中等收入国家的资源限制使得有必要制定伤害预防策略，并在伤害预防措施失败时优化当地现有资源的利用。这将为重症和受伤儿童带来尽可能好的治疗效果。低收入和中等收入国家的政府单独或与国际非政府组织（NGO）合作，致力于为其公民提供充足医疗保健，这对于改善重大创伤后的生存率也至关重要。全球冲突的增加也对儿童产生了显著的有害影响，政府和联合国等国际组织在减少这些影响方面可发挥重要作用。本综述详细介绍了儿科患者创伤性损伤的评估和管理，并对改善低收入和中等收入国家的创伤护理提出了一些建议。
