The Regional Pediatric Trauma Center at Schneider Children's Hospital
was established in 1996 to meet the needs of critically injured
children in the region. The New York State Department of Health
designated the pediatric trauma center as the first regional pediatric
trauma center in the entire downstate/Long Island region. To date
the Regional Pediatric Trauma Center at Schneider Children's Hospital
is one of only three such centers in all of New York State that
has received this designation. In a recent survey of the trauma
centers in New York City by the New York State Department of Health,
the Regional Pediatric Trauma Center at SCH was noted to have set
the standard for pediatric trauma care not just in New York City
but all of New York State and serves as a model for care of the
critically injured child.
The Regional Pediatric Trauma
Center is under the direction of the Division of Pediatric Surgery
of Schneider Children's Hospital. As of 2004, over 1200 pediatric
patients have been admitted to SCH with trauma related diagnoses
making SCH the region's leader in care of the critically injured
child. The Director of the Regional Pediatric Trauma Center is
Dr. Nelson Rosen, M.D. and Mr. George Berry, MPAS, PA-C is the
full-time pediatric trauma coordinator.
The Problem
The number one cause of pediatric
mortality ages one through 17 is trauma. There are more deaths
annually in the pediatric population from trauma than all other
causes of death combined, including infectious disease, cardiac
conditions, congenital malformations, respiratory diseases et
al. In a recent special report on pediatric trauma in New York
State, published in 2002 by the NYS DOH, 20% of all patients meeting
major trauma criteria were children. Pediatric trauma patients
in the five boroughs of New York City accounted for one-third
of those same patients. Falls, motor vehicle accidents, pedestrians/bicyclists
struck by cars, assaults, recreational/sporting injuries, and
child abuse are some of the leading causes of pediatric mortality
and morbidity.
Response to the Problem
Studies have shown that adult
trauma patients have better outcomes and are better served in
facilities designated as trauma centers. The same is true for
the injured child. Children are not little adults and as such
have different anatomic and physiologic responses to injury. These
differences are best identified and managed by pediatric specialists
and sub-specialists who care for injured children on a regular
basis.
When notification is received
by the Pediatric Emergency Dept. staff that an injured child is
to arrive, the in-house pediatric trauma team is activated through
a group page. In house 24/7 the team consists of a chief resident
in surgery; an attending anesthesiologist; a respiratory therapist;
a junior surgical resident; a pediatric critical care fellow and
pediatric ICU nurse; and a board certified attending physician
in pediatric emergency medicine. Specially trained pediatric emergency
department nurses are an integral part of the team.
All care is supervised by board-certified
pediatric surgeons. Management and treatment of the injured child
is done in two specially equipped pediatric resuscitation bays
in the Emergency Department. The pediatric trauma team is supplemented
by a broad range of services including specialists in pediatric
orthopedics, radiology, neurosurgery, urology, vascular surgery,
ENT, OMF, and plastic surgery. Physician members of the team are
required to take training in Advanced Trauma Life Support (ATLS)
and Pediatric Advanced Life Support (PALS). Nurses are required
to take the Trauma Nursing Core Curriculum Course (TNCC) in addition
to PALS.
Interfacility
Transport
Many injured children are transported
to the Regional Pediatric Trauma Center after having been initially
stabilized at a local, community hospital. The children's hospital
with the cooperation of the Center for Emergency Medical Services
operates a fleet of modern, specially-equipped ambulances that
transport injured children to SCH. Critical care nurses and paramedics
continue stabilization of the patient between facilities.
PEDIATRIC
TRAUMA TRANSPORT PHONE NUMBER:
(516) 719-KIDS
