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At our level I paediatric trauma centre in the USA, our team includes a paediatric emergency medicine attending, a paediatric emergency medicine fellow, a trauma surgeon, a surgery nurse practitioner, an anaesthesiologist, multiple trauma-trained nurses, a respiratory therapist, an X-ray technician, a pharmacist, a phlebotomist and a recorder. The paediatric emergency team coordinates care with EMS before the child arrives to the hospital and the entire team is most often fully assembled and briefed 5–10 min before the child arrives.
At the hospital where we work in Malawi, when a trauma patient rolls in, the job of the entire trauma team above is done by a single surgery intern due to severe staff shortage. And, if the injured patient is a child, they may not be seen by a paediatric health professional during the entirety of their hospitalisation.
Although injuries affect all age groups, they have a particular impact on children and adolescents and are responsible for over 900 000 deaths/year globally in children 18 years and younger.1 Unintentional injuries account for almost 90% of these injuries and are among the top three causes of death among children aged 5–19 years worldwide.1 The global burden of injury on children falls unequally, and children living in low-income and middle-income countries (LMICs) are much more likely to be injured. In fact, more than 95% of all injury-related deaths in children occur in LMICs, with only the remaining 5% occurring in high-income countries (HICs).1 Thus, a global focus on injury prevention together with investment and research in optimal care for injured children in LMICs should become more urgent for paediatricians, emergency room physicians, intensivists and surgical subspecialists engaged in global child health partnerships, advocacy and research.
In recent decades, interventions to improve child survival have targeted infectious diseases and nutritional …
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