NCEPOD: Trauma - Who Cares? - London Health Programmes

CHAPTER 9 - Paediatric careKey findingsRecommendations68/795 (8.6%) cases were aged 16 or less.Only 54% of cases had consultant staff involved in theimmediate management.The pattern of assessment of overall care was similar toadults with less than half the cases judged as receivingcare classifi ed as good practice.Advanced Paediatric Life Support (APLS) trained staffwere not resident or available 24 hours in 20.2% ofhospitals.Only 22 out of 146 hospitals had Registered SickChildren’s Nurse cover 24 hours a day, 7 days a week.All recommendations in this report apply equally toseverely injured children.All sites accepting children for defi nitive traumamanagement should have protocols for theirmanagement in place. These protocols should beregularly reviewed and updated. (Hospital trusts)All hospitals should have up to date guidelines on themanagement and referral of suspected non-accidentalinjury in children. (Hospital trusts)Hospitals should use standard, universal defi nitionsfor neonates, infants and children. (Royal College ofPaediatrics and Child Health)Each receiving unit should have up to date guidelines forchildren which recognise the paediatric skills available onsite and their limitations and include agreed guidelinesfor communication and transfer with specialisedpaediatric services within the local clinical network.(Strategic health authorities and hospital trusts)An Advanced Paediatric Life Support (APLS) (orequivalent) trained consultant and a Registered SickChildren’s Nurse (RSCN) or an APLS trained nurseshould be involved in the immediate management of allseverely injured children. (Hospital trusts)If a hospital does not admit children for defi nitive carethen a bypass protocol should be in place. (Hospital andambulance trusts)116