ADULT TRAUMA SURGEONS WITH PEDIATRIC COMMITMENT - A LOGICAL SOLUTION TO THE PEDIATRIC TRAUMA MANPOWER PROBLEM

Pediatric trauma care by ''adult'' surgeons is debated, despite the pa ucity of pediatric trauma surgeons; 424 patients less than or equal to 17 admitted to a Level I Center run by ''adult'' surgeons were analyz ed. Demographics mirrored NPTR (mean ISS 11.5; mean age 10). ''Adult'' critical care surgeons treated MTOS-comparable patients with outcomes comparable to MTOS. Among other specialists, only neurosurgeons saw a MTOS-comparable population. Nonoperative protocols for solid organ in jury were used appropriately, Z for all patients was +0.17 with M 0.90 8. Ps was 0.951; actual survival was 0.958 with 18 deaths (mean Ps 0.1 58). There were two unexpected survivors and one unexpected death; 73% of survivors had age-appropriate locomotion. Pediatric trauma outcome s by ''adult'' surgeons compare favorably to national standards. The r ecommendation that pediatric trauma care be directed by pediatric surg eons should be qualified in view of such outcomes and the paucity of p ediatric trauma surgeons.