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The Hidden World of Childhood Trauma: Why Does Trauma Care for Kids Require Unique Expertise?
Childhood trauma, or pediatric trauma, involves traumatic injuries sustained by infants, children, or adolescents. Because children differ significantly from adults in anatomy and physiology, the care and management of this population also differs.
Differences between Anatomy and Physiology
First, there are significant anatomical and physiological differences between children and adults. For example, children's internal organs are closer to each other, which puts them at higher risk when faced with trauma. These unique characteristics make children a challenge in trauma care.
"Among injured children, the risk of death is lower when they are treated in a pediatric trauma center. However, approximately 10% of injured children are treated in non-pediatric trauma centers."
Statistics show that the highest mortality rates occur among children who are treated in remote areas where there are no trauma centers. Weight estimation is an important part of pediatric trauma management. There are many methods of weight estimation including Broselow tape and Theron formula, of which Broselow tape is the most accurate in estimating weight for children less than 25 kg.
Diagnosis
In terms of diagnosis, several classification systems have been developed that aim to quantify the severity of trauma using both subjective and objective data. These systems include the Trauma Severity Index and the Revised Glasgow Coma Scale, among others. The Children's Glasgow Coma Scale and the Children's Trauma Scoring System (PTS), which are specially designed for children, can better reflect their vulnerability to trauma.
“The minimum score on the Pediatric Trauma Scoring System is -6 and the maximum score is +12. The lower the trauma score, the higher the risk of death.”
However, all of these scoring systems have limitations when applied to pediatric patients. Therefore, providers often use classification systems that have been modified or developed specifically for the pediatric population for evaluation.
Management
Managing childhood trauma requires a deep understanding of the physiological, anatomical, and developmental differences between children, which requires specialized expertise. Data show that in rural healthcare settings, treatment of pediatric patients is often hampered by a lack of knowledge and resources. Even though there is little difference in outcomes among adult trauma centers, the specialized care received in pediatric trauma centers significantly improves outcomes.
EpidemiologySerious injuries kill nearly 10,000 children in the United States each year, according to the Centers for Disease Control and Prevention. In 2004, childhood trauma accounted for 59.5% of all deaths among children under 18 years of age. Injuries have become the leading cause of death in this age group, surpassing all other causes combined.
"Each year, approximately 16,000,000 children in the United States seek medical attention for injuries, and boys are injured at twice the rate of girls."
In the home environment, cleaning agents and other chemicals also cause accidental injuries to young children, such as chemical eye burns, while puncture wounds are often caused by household items that children come into contact with on a daily basis.
Conclusion
Trauma treatment for children requires specialized knowledge and skills to accommodate their unique physiological and psychological characteristics. In this challenging field, how can medical professionals ensure they are providing the best possible care for every injured child?
