Kids and Cars by Dr. Meredith

Toddler in car seatMotor vehicle crashes are the number one cause of death from injury in children. It’s more than 50 percent of all pediatric trauma injuries, according to the Centers for Disease Control and Prevention.

The number of deaths spike sharply as kids approach getting their driver’s license. There’s a great deal we can do in terms of preventing deaths and injuries. Those prevention strategies include driver’s license strategies, drinking and driving strategies, automobile design and safety strategies, all of which have been effective and need to significant resources investments to continue and improve.

It is safer on our highways than it’s ever been before. Per vehicle mile driven there are fewer deaths both in children and in everyone else. Nonetheless, it will be a long, long time before we eliminate motor vehicle crashes as a cause of injury or a cause of death.

Until that time occurs, another strategy that needs to be implemented is the development of trauma systems so that kids who are injured in crashes can be identified. Researchers are working on automatic crash notification systems that will identify if people are likely to have significant injuries in them and notify the system automatically.

You think about commercials of cars that look for the crash potentials, automatically slow down and proactively help the driver. It is equally possible for a car to sense how severe a crash is and automatically notify folks, from notification through the response. Once EMS is notified, they need to have localized people who can get to crashes quickly. When they arrive they need to have the training, expertise and equipment that is necessary to recognize and treat the injuries.

In addition to funding crash notification research, the Childress Institute is committed to developing and providing training programs for all health care professionals. Surgeons, who treat mostly adults, need extra help in knowing how to treat kids. It’s not as common and it’s so emotionally charged which makes it difficult. The same thing is true for paramedics. They need that training and we’re committed to developing it and disseminating educational programs for first responders.

When an injury occurs, we need a good trauma system that can recognize kids with triage protocols. Responders need to comprehend who has injuries that require trauma center care and have ready access to get to trauma centers.

There are not enough trauma centers or pediatric trauma centers in our country. There’s not enough coordination of the children’s hospitals with the trauma centers and the trauma systems in our country. The Childress institute is working very hard to foster the development of more children’s hospitals becoming trauma centers. We have worked very hard to support the Pediatric Trauma Society, which is a group of professionals whose goal is to further the knowledge and develop trauma systems and improve trauma centers.

The last piece of the puzzle is the actual care of injury victims and understanding more. So much of the treatment for these high energy crashes and the injuries that occur in them comes from extrapolation of injuries that occur in adults and the way we treat them. The research that is necessary to figure out the best way to treat specific injuries in children has not yet been done. And it must be.

The Childress Institute has already funded research investigating the relationship of shock and head injury, which are the top two causes of death from trauma in children from car crashes. The outcomes of this research could be revolutionary for the treatment of injured children. It’s full impact and how generalizable that is, needs further research. We need to be at the forefront of helping get that done and we need funding to help us make that kind of research a reality. Then after we develop new knowledge, we need better tools to disseminate that knowledge to the caregivers in our country.

Currently it takes sometimes ten years for new knowledge to become the standard of care widely used. We need to shorten that cycle time. Can you imagine the cycle time of learning to develop a new way of setting up the shock absorbers for a certain race track? If that took ten years, many teams would be extinct. You have to make these turnarounds at least every week. Health care needs to get there and trauma leaders need to forge the path.

Dr. J. Wayne. Meredith, Medical Advisor, Childress Institute for Pediatric Trauma

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