Trauma is the leading cause of death in childhood, with a higher incidence in boys, with road traffic accidents and falls accounting for 80% of injuries. The initial assessment follows the same principles as in adults, the first priority being Airway, Breathing and then Circulation, but there are additional considerations at every step of the assessment.

Additional points to consider when preparing for the arrival of a paediatric trauma patient:

1. ▪ Delegating team member roles: this is particularly important with children as not only are the trauma team present but the pediatricians, paediatric intensive care unit (PICU) staff and paediatric anaesthetists may all be present. Swift and clear team leadership is required to run an efficient trauma team, with relevant specialists called upon when required.

2. ▪ Unlike adult trauma victims, childhood trauma also involves the parents. Early on the parent(s) needs to be cared for by a single delegated member of staff who can provide ongoing support to the family and also take a considered history during the resuscitation. Parents may often request to be present during the resuscitation; such requests need to be respected and given due care and consideration but reassessed repeatedly during the ongoing resuscitation. To calm children during a trauma, it may be helpful for a familiar voice and face (a single member of the family/friend) to be present at the head end of the child.

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