REGIONAL REVIEW OF BLUNT TRAUMA IN CHILDREN

Seventy-five severely injured children (Inj my Severity Score greater than 15 or death) were identified during a 1-year prospective audit of all severe trauma in a single region. Fourteen children were admitted primarily to the regional children's hospital, comprising 0.2 per cen t of that accident and emergency department workload. Paediatric traum a admissions to the 15 district general hospitals; averaged 3.1 childr en per hospital per year or 0.007 per cent of the accident and emergen cy department attendances. There were 38 deaths (51 per cent), of whic h 15 occurred before admission to hospital. Significant deficiencies i n acute management were identified at both types of hospital. There is a need to improve trauma management of children at tertiary care leve l and district general hospitals by developing trauma management proto cols. The low number of severely injured children presenting to the di strict general hospitals suggests the need for a regional trauma syste m.