Maximum survival in pediatric trauma: the ideal system

Abstract

One hundred consecutive pediatric trauma deaths (0.01-18 yrs) were analyzed for their survival potential in an optimally functioning EMS/Trauma system in Mobile, Alabama (1980-1982). Thorough evaluation of all phases of care by paramedic run sheets, ER records, hospital records, and autopsy reports, revealed that 47/100 victims could have never survived due to the extreme nature of their injuries, and 53/100 victims had the potential of surviving if the EMS/Trauma system functioned optimally. Errors in care were identified in those cases deemed potentially salvageable. Identification phase errors were found in 79% of potentially salvageable victims. Field treatment errors occurred in 36%, transport errors in 23%, and definitive care errors in 17% of those considered to be potentially salvageable. By evaluating where in an EMS/Trauma system errors occur and then by correcting those errors, it should be possible to minimize the mortality rate in pediatric trauma.