Pediatric Readiness and Trauma Centers: History, Relevance, and Practical Application

Abstract

Abstract Purpose of Review New optimal standards for the care of the injured patient released in 2022 by the American College of Surgeons now include a requirement for trauma centers—adult and pediatric—to assess their own pediatric readiness and take steps to address any gaps. Recent Findings Timely access to high-quality initial resuscitative care for injured children is essential. While the benefit of pediatric trauma centers has been demonstrated, initial post-injury care is often provided at non-pediatric centers due to limited access to this resource. The National Pediatric Readiness Project (NPRP) has outlined a framework for ensuring preparedness for pediatric emergency care in the emergency department, including pediatric trauma care. Pediatric readiness can be quantified by the weighted pediatric readiness score (wPRS). Critically ill and injured children initially treated at emergency departments with higher levels of pediatric readiness have been associated with improved mortality. While pediatric trauma centers have high levels of pediatric readiness, non-pediatric centers have been shown to have significantly lower levels of pediatric readiness—despite a large number of children gaining access to the trauma system. Summary This manuscript is intended as a comprehensive review of the pediatric readiness project: its history, its impact on US trauma center outcomes, and its application via the use of the pediatric readiness assessment and toolkit within an individual trauma center. This review is intended to be a practical guide to ensure that every trauma hospital is ready and able to provide quality triage and initial resuscitation of an injured child in their emergency department.