From the Department of Surgery (C.Q.S.), University of California-San Francisco, San Francisco, CA; and Hiram C. Polk Jr Department of Surgery, University of Louisville School of Medicine (M.E.F.), Louisville, KY.
J Trauma Acute Care Surg. 2024 May 1;96(5):838-850. doi: 10.1097/TA.0000000000004208. Epub 2023 Nov 16.
Pediatric trauma system development is essential to public health infrastructure and pediatric health systems. Currently, trauma systems are managed at the state level, with significant variation in consideration of pediatric needs. A recently developed Pediatric Trauma System Assessment Score (PTSAS) demonstrated that states with lower PTSAS have increased pediatric mortality from trauma. Critical gaps are identified within six PTSAS domains: Legislation and Funding, Access to Care, Injury Prevention and Recognition, Disaster, Quality Improvement and Trauma Registry, and Pediatric Readiness. For each gap, a recommendation is provided regarding the necessary steps to address these challenges. Existing national organizations, including governmental, professional, and advocacy, highlight the potential partnerships that could be fostered to support efforts to address existing gaps. The organizations created under the US administration are described to highlight the ongoing efforts to support the development of pediatric emergency health systems.It is no longer sufficient to describe the disparities in pediatric trauma outcomes without taking action to ensure that the health system is equipped to manage injured children. By capitalizing on organizations that intersect with trauma and emergency systems to address known gaps, we can reduce the impact of injury on all children across the United States.
儿科创伤系统的发展对于公共卫生基础设施和儿科卫生系统至关重要。目前,创伤系统由州一级管理,在考虑儿科需求方面存在显著差异。最近开发的儿科创伤系统评估评分(PTSAS)表明, PTSAS 较低的州,其儿童创伤死亡率更高。在六个 PTSAS 领域中发现了关键差距:立法和资金、获得护理、伤害预防和识别、灾害、质量改进和创伤登记处以及儿科准备。对于每个差距,都提供了关于解决这些挑战所需步骤的建议。现有的国家组织,包括政府、专业和宣传组织,强调了可以促进的潜在伙伴关系,以支持解决现有差距的努力。描述了在美国政府领导下创建的组织,以强调正在进行的努力,以支持儿科急诊卫生系统的发展。如果不采取行动确保卫生系统有能力救治受伤儿童,仅仅描述儿科创伤结局的差异是不够的。通过利用与创伤和急救系统交叉的组织来解决已知差距,我们可以减少全美所有儿童受伤的影响。