Doctors Need Trauma Education

Young doctor with child in hospital patient health safety save injured kids wheelchairI attended the 28th Eastern Association for the Surgery of Trauma (EAST) Annual Scientific Assembly earlier this year and wanted to share what doctors across the U.S. are doing to help your kids behind the scene. EAST is one of the major trauma organizations, a scientific body and collegial organization for people interested in trauma care. Most EAST members have done fellowship training in trauma and primarily take care of adults. There’s not a dedicated pediatric focus but it’s a good organization to be involved with for people who care about pediatric trauma.

Only about 25 percent of injured children are cared for at dedicated pediatric trauma centers by full-time pediatric trauma specialists. Most children receive their care from people who care primarily for adults, and EAST is an opportunity for adults and pediatric trauma specialists to interact.

EAST is geared toward the development of evidence-based guidelines, in addition to presenting new scientific research. A group in Missouri is studying regionalized trauma care and they found that there were better outcomes for long-term survival and function after they had regionalized their trauma system. There were several papers presented regarding trauma resuscitation.

There was also a paper on monitoring for traumatic brain injury where using advanced computer software can measure very slight changes in patients in the ICU, such as blood pressure and pulse rate. With some analysis by the software, they could predict adverse events in the ICU, anticipate problems sooner and provide preventative treatment.

EAST is the premier guidelines organization in trauma, adult or pediatrics, and they have a long history of distributing good, evidence-based guidelines. EAST has a link on their website that gets thousands of hits a day from clinicians searching for answers to problems they’re facing with patients in their care. This year, they had a guideline on ATV safety and gun violence injury prevention, reviewing different states’ legislation.

They also presented a guideline on family presence in trauma resuscitation, which is something pediatric specialists have been doing for a while. Even while treating a critically-injured patient, can we make a way for families to be with somebody they love? We have to realize that for some of those patients it may be the final moments of their life and we need to find a way for them to be with somebody that they care about. It’s great to see some things that have been traditionally more pediatric focused are gaining some traction in the adult trauma care world.

We had an ad hoc pediatric trauma committee there, many familiar faces from the Pediatric Trauma Society with a real commitment among ourselves to continue to support EAST in its mission. EAST looks to the pediatric specialists to help generate that research so that those guidelines can be evidence-based, and be evaluated and used by people all over the world. They’ve also opened the door for us to teach sessions on pediatric trauma topics.

So many adult trauma care providers also take care of children so we can’t abandon our commitment to adult trauma care because there are many more adult fellowship-trained people taking care of children than there are pediatric specialty people. It was a fruitful time and it’s a meeting I look forward to every year. I always come back from the EAST meeting excited and full of good ideas for helping Save Injured Kids.

Dr. John Petty, Associate Professor of Surgery in Pediatrics and the Program Director for the Pediatric Child Program at Brenner Children’s Hospital at Wake Forest Baptist Medical Center

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