Wednesday, July 30, 2014

Saving Kids Worldwide

One of the leading causes of death worldwide is injury to children, especially between 1-14 years of age. Most people are unaware that injury should be considered a disease. There is so much awareness of the benefits of immunization to prevent childhood disease but injury continues unabated. Action to prevent injury and death will save the lives of children and reduce the disability that results.

Worldwide, the challenge is the “burden of injury” which creates a significant economic and social impact upon the family, community and society. The effect upon the family is significant: absence of the child from school, loss of employment by the parent, reduction in income for the family who must care for the child and isolation of the family from the community. After a child steps upon a landmine or plays with unexploded ordinance, the mobility of the child is eliminated after an amputation of an extremity. In many cultures the family is shunned by the community. The “burden” affects the entire community that is responsible to provide a safe environment for the child. Surgeons can prevent death, improve the quality of life and provide a chance for rehabilitation following disability from injury.

Nevertheless, about 10% of the injuries to children worldwide challenge the best surgeons and health care systems. We rely upon a team of people to help save children once they are injured. It takes a system that includes response at the point of injury, acute treatment and a commitment to rehabilitation, to prevent the death of the child and restore them to health. The initial response time has impact upon the outcome. It is imperative that we prepare the first responder and the Emergency Medical System to save the life of the child and to provide transfer to an appropriate level of trauma care.

Sudden events that result in injuries, such as earthquakes, riots or political conflicts, create a challenge for all levels of the system. It takes a long time before you have a response by emergency services, so the bystander and local team need to be able to initiate emergency care while providing transfer to a facility for acute treatment. In the United States, only 10% of injured children have access to a verified pediatric trauma center, so that means 90% receive acute care in general hospital facilities.

The big question is “how do we take care of these kids no matter where they are in the world?” After 10 years of war in Iraq and Afghanistan, the approach to care for the injured child changed. This knowledge and experience affects the system of care and the approach to treatment that makes a difference to children. Better prevention, acute care and rehabilitation will improve the quality of life for the community.

A community has the opportunity to learn from the global experience with injury or to share them with colleagues throughout the world. The convenience and accessibility of using web-based technology can share life-saving ideas quickly. We now can provide access to new surgical techniques and to accelerate practical application in a matter of weeks, instead of years. As an example, The Childress Institute for Pediatric Trauma creates web symposia to provide cutting-edge practice to medical professionals in 33 countries over the past two years.

The timely transfer of pediatric trauma care knowledge is saving the lives of injured children worldwide. The challenge to provide contemporary trauma care to the worldwide community is worthy of our efforts. 

- MartinR. Eichelberger, M.D., Professor of Surgery and of Pediatrics at George Washington University, Children’s National Medical Center in Washington D.C.

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