Skip to main content

Management of Paediatric Trauma in an Austere Environment

  • Chapter
  • First Online:
Ballistic Trauma

Abstract

The Uppsala Conflict Data Programme held by Uppsala university reported 149 state and non-state conflicts worldwide in 2015, with over 118,000 deaths [1]. By inference, humanitarian, training, and peacekeeping missions are necessary to provide medical support to those injured in these conflicts. The presence of such military medical facilities will inevitably create pressure to provide emergency medical treatment for children and other civilians. This is exacerbated by the destabilising effects of conflict on local healthcare systems, which may arise from destruction of facilities, lack of supplies, or lack of trained staff. Such systems may also have limited resources to begin with, and the additional workload and resource requirement may prove unmanageable. It is difficult to deny the devastated parents, presenting with a grotesquely injured child, the possibility of treatment. Regardless of the intended mission, medical teams working in conflict areas therefore need to be prepared to manage paediatric trauma safely, and effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. The Uppsala Conflict Data Program. http://ucdp.uu.se. Accessed 24 Dec 2016.

  2. Pearn J. Pediatric diseases and operational deployments. Mil Med. 2000;165(4):283–6.

    CAS  PubMed  Google Scholar 

  3. Farrow GB, Rosenfeld JV, Crozier JA, et al. Military surgery in Rwanda. Aust N Z J Surg. 1997;67(10):696–702.

    Article  CAS  PubMed  Google Scholar 

  4. Batinica J, Batinica S. War wounds in the Sibenik area during the 1991-1992 war against Croatia. Mil Med. 1995;160(3):124–8.

    CAS  PubMed  Google Scholar 

  5. Haddock G, Pollok AJ. Paediatric trauma in northern Iraq: the Kurdish refugee crisis. J R Coll Surg Edinb. 1992;37(4):221–4.

    CAS  PubMed  Google Scholar 

  6. McGuigan R, Spinella PC, Beekley A, et al. Pediatric trauma: experience of a combat support hospital in Iraq. J Pediatr Surg. 2007;42(1):207–10.

    Article  PubMed  Google Scholar 

  7. Heller D. Child patients in a field hospital during the 2003 Gulf conflict. J R Army Med Corps. 2005;151(1):41–3.

    CAS  PubMed  Google Scholar 

  8. Gurney I. Paediatric casualties during OP TELIC. J R Army Med Corps. 2004;150(4):270–2.

    Article  CAS  PubMed  Google Scholar 

  9. Creamer KM, Edwards MJ, Shields CH, et al. Pediatric wartime admissions to US military combat support hospitals in Afghanistan and Iraq: learning from the first 2,000 admissions. J Trauma. 2009;67(4):762–8.

    Article  PubMed  Google Scholar 

  10. Borgman M, Matos RI, Blackbourne LH, et al. Ten years of military pediatric care in Afghanistan and Iraq. J Trauma. 2012;73(6 Suppl 5):S509–13.

    Article  Google Scholar 

  11. Arul GS, Reynolds J, DiRusso S, et al. Paediatric admissions to the British Military Hospital at Camp Bastion, Afghanistan. Ann R Coll Surg Engl. 2012;94:52–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Beitler AL, Wortmann GW, Hofmann LJ, et al. Operation enduring freedom: the 48th Combat Support Hospital in Afghanistan. Mil Med. 2006;171(3):189–93.

    Article  PubMed  Google Scholar 

  13. Aharonson-Daniel L, Waisman Y, Dannon YL, et al. Epidemiology of terror-related versus non-terror-related traumatic injury in children. Pediatrics. 2003;112:e280–4.

    Article  PubMed  Google Scholar 

  14. Edwards M, Lustik M, Carlson T, et al. Surgical interventions for pediatric blast injury: an analysis from Afghanistan and Iraq 2002-2010. J Trauma Acute Care Surg. 2014;77(2):389.

    Google Scholar 

  15. Villamaria CY, Morrison JJ, Fitzpatrick CM, Cannon JW, Rasmussen TE. Wartime vascular injuries in the pediatric population of Iraq and Afghanistan: 2002-2011. J Pediatr Surg. 2014;49(3):428–32.

    Article  PubMed  Google Scholar 

  16. Edwards M, Lustik M, Eichelberger M, et al. Blast injury in children: an Analysis from Afghanistan and Iraq. J Trauma Acute Care Surg. 2012;73(5):1278–83.

    Article  PubMed  Google Scholar 

  17. Bilukha OO, Brennan M, Anderson M, et al. Seen but not heard: injuries and deaths from landmines and unexploded ordnance in Chechnya, 1994-2005. Prehosp Disaster Med. 2007;22(6):507–12.

    Article  PubMed  Google Scholar 

  18. Bendinelli C. Effects of land mines and unexploded ordnance on the pediatric population and comparison with adults in rural Cambodia. World J Surg. 2009;33(5):1070–4.

    Article  PubMed  Google Scholar 

  19. Kosashvili Y, Aharonson-Daniel L, Peleg K, et al. Israeli hospital preparedness for terrorism-related multiple casualty incidents: can the surge capacity and injury severity distribution be better predicted? Injury. 2009;40(7):727–31.

    Article  PubMed  Google Scholar 

  20. Quintana D, Jordan F, Tuggle D, et al. The spectrum of pediatric injuries after a bomb blast. J Pediatr Surg. 1998;32(2):307–11.

    Article  Google Scholar 

  21. Savitsky B, Aharonson-Daniel L, Giveon A, et al. Variability in pediatric injury patterns by age and ethnic groups in Israel. Ethn Health. 2007;12(2):129–39.

    Article  PubMed  Google Scholar 

  22. Waisman Y, Aharonson-Daniel L, Mor M, et al. The impact of terrorism on children: a two-year experience. Prehosp Disaster Med. 2003;18(3):242–8.

    Article  PubMed  Google Scholar 

  23. Bayreuther J, Wagener S, Woodford M, et al. Paediatric trauma: injury pattern and mortality in the UK. Arch Dis Child Educ Pract Ed. 2009;94(2):37–41.

    Article  CAS  PubMed  Google Scholar 

  24. Jaffe DH, Kobi P, Israel Trauma Group. Terror explosive injuries: a comparison of children, adolescents, and adults. Ann Surg. 2010;251:138–43.

    Article  PubMed  Google Scholar 

  25. Mercer SJ, Whittle C, Siggers B, Frazer RS. Simulation, human factors and defence anaesthesia. J R Army Med Corps. 2010;156(4 Suppl 1):365–9.

    Article  CAS  PubMed  Google Scholar 

  26. Nordmann GR, McNicholas JJ, Templeton PA, et al. Paediatric trauma management on deployment. J R Army Med Corps. 2011;157(3 Suppl 1):S334–43.

    Article  CAS  PubMed  Google Scholar 

  27. Nance ML, Carr BG, Kallan MJ, et al. Variation in pediatric and adolescent firearm mortality rates in rural and urban US counties. Pediatrics. 2010;125(6):1112–8.

    Article  PubMed  Google Scholar 

  28. Leventhal JM, Gaither JR, Sege R. Hospitalizations due to firearm injuries in children and adolescents. Pediatrics. 2014;133(2):219–25.

    Article  PubMed  Google Scholar 

  29. Snyder CW, Muensterer OJ, Sacco F, et al. Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children. Int J Circumpolar Health. 2014;73:25066.

    Article  PubMed  Google Scholar 

  30. Campbell NM, Colville JG, van der Heyde Y, et al. Firearm injuries to children in Cape Town, South Africa: impact of the 2004 Firearms Control Act. S Afr J Surg. 2013;51(3):92–6.

    Article  CAS  PubMed  Google Scholar 

  31. Inwald D, Arul G, Montgomery M, Henning J, McNicholas J, Bree S. Management of children in the deployed intensive care unit at Camp Bastion, Afghanistan. J R Army Med Corps. 2014;160(3):236–40.

    Article  PubMed  Google Scholar 

  32. Nordmann GR. Paediatric anaesthesia in Afghanistan: a review of the current experience. J R Army Med Corps. 2010;156(4 Suppl 1):323–6.

    Article  CAS  PubMed  Google Scholar 

  33. Mohseni S, Talving P, Castelo Branco B, et al. Effect of age on cervical spine injury in pediatric population: a National Trauma Data Bank review. J Pediatr Surg. 2011;46:1771–6.

    Article  PubMed  Google Scholar 

  34. Pieretti-Vanmarcke R, Velmahos GC, Nance ML, et al. Clinical clearance of the cervical spine in blunt trauma patients younger than 3 years: a multi-center study of the American Association for the Surgery of Trauma. J Trauma. 2009;67(3):543–50.

    Article  PubMed  Google Scholar 

  35. Paal P, Gordon L, Strapazzon G, et al. Accidental hypothermia—an update. Scand J Trauma Resusc Emerg Med. 2016;24:111.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bree S, Wood K, Nordmann GR, et al. The paediatric transfusion challenge on deployed operations. J R Army Med Corps. 2010;156(4 Suppl 1):361–4.

    Article  CAS  PubMed  Google Scholar 

  37. Mathew P, Gibbons AJ, Christie M, et al. Operative treatment of paediatric penetrating head injuries in southern Afghanistan. Br J Neurosurg. 2013;27(4):489–96.

    Article  CAS  PubMed  Google Scholar 

  38. Fuenfer MM, Creamer KM. Pediatric surgery and medicine for hostile environments. http://www.bordeninstitute.army.mil/other_pub/pediatric.html.

  39. Singh A. Basic symptom control in paediatric palliative care. The rainbows children’s hospice guidelines. 9.5th ed. 2016. www.ppcscm.co.uk. Accessed 24 Dec 2016.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G. Suren Arul .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Tremlett, W., Breeze, J., Suren Arul, G. (2017). Management of Paediatric Trauma in an Austere Environment. In: Breeze, J., Penn-Barwell, J., Keene, D., O'Reilly, D., Jeyanathan, J., Mahoney, P. (eds) Ballistic Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-61364-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-61364-2_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61363-5

  • Online ISBN: 978-3-319-61364-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics