“Children are different” but, remarkably, very little work has been published which permits an analysis of paediatric trauma care. The main TARN database contains information on over 35,000* children under the age of sixteen and has been a valuable asset. For example it has been used to demonstrate improvements in outcome during the 1990s**. However many aspects of paediatric trauma assessment and management differ significantly from adult trauma care and it has been recognised that the data collection form, designed for adults, requires some changes for children.
In the UK there are very few trauma systems designed exclusively for children but the variation in provision could, perhaps, be described as a natural experiment waiting to be analysed. Are paediatric trauma services better when they are integrated within a children’s hospital or is the system more effective when adult and children’s trauma services are mixed?
‘TARNLET’ was established in 2000 to address these and other questions relating to paediatric trauma care. A discrete paediatric group has been formed and a separate data collection form will be evaluated. A focused paediatric element to the database with more detailed information, particularly about the characteristics of the trauma service, will undoubtedly provide a valuable statistical platform on which to debate the future provision of paediatric services.
*Figure as of June 2011
**Reducing accident rates in children and young adults: the contribution of hospital care.
I Roberts, F Campbell, S Hollis, D Yates on behalf of the Steering Committee of the Major Trauma Outcome Study Group (now TARN): BMJ 313 1239-1241. ..........................................................................................................................................................................................
Paediatric Publications (TARN Database)
Variation in recording of child maltreatment in administrative records of hospital admissions for injury in England, 1997 - 2009
Arturo González-Izquierdo, Jenny Woodman, Lynn Copley, Jan van der Meulen, Marian Brandon, Deborah Hodes, Fiona Lecky, Ruth Gilbert
Arch Dis Child 2010;95:918-925
Screening injured children for physical abuse or neglect in emergency departments: a systematic review
J Woodman, F Lecky, D Hodes, M Pitt, B Taylor, R Gilbert
Child: Care, Health & Development 2009, Volume 36: 2; 153-164
Paediatric trauma: injury pattern and mortality in the UK
Jane Bayreuther, Silke Wagener, Maralyn Woodford, Antoinette Edwards, Fiona Lecky, Omar Bouamra, Evelyn Dykes
Arch. Dis. Child. Ed. Pract. 2009;94;37-41
The Utilisation of intraosseous infusion in the resuscitation of paediatric major trauma patients
Smith R, Davis N, Bouamra O, Lecky F
Injury 2005;36:1034-1038
Patterns and risks in spinal trauma
Martin BW, Dykes E, Lecky FE
Archives of Disease in Childhood 2004;89:860-865
Systolic hypertension and the response to blunt trauma in infants and children
Dark P, Woodford M, Vail A, Mackway-Jones K, Yates D, Lecky F
Resuscitation 2002 54;3;245-253