"Adult" trauma surgeons with pediatric commitment: a logical solution to the pediatric trauma manpower problem

Abstract

Pediatric trauma care by "adult" surgeons is debated, despite the paucity of pediatric trauma surgeons; 424 patients < or = 17 admitted to a Level I Center run by "adult" surgeons were analyzed. Demographics mirrored NPTR (mean ISS 11.5; mean age 10). "Adult" critical care surgeons treated MTOS-comparable patients with outcomes comparable to MTOS. Among other specialists, only neurosurgeons saw a MTOS-comparable population. Nonoperative protocols for solid organ injury were used appropriately. Z for all patients was +0.17 with M 0.908. Ps was 0.951; acute survival was 0.958 with 18 deaths (mean Ps 0.158). There were two unexpected survivors and one unexpected death; 73% of survivors had age-appropriate locomotion. Pediatric trauma outcomes by "adult" surgeons compare favorably to national standards. The recommendation that pediatric trauma care be directed by pediatric surgeons should be qualified in view of such outcomes and the paucity of pediatric trauma surgeons.