Paediatric Trauma Care

When a child has been seriously injured, it is a very worrying and often confusing time for families, and may be a child's first experience of acute care. The following provides some general information about the kind of treatments provided in a paediatric trauma unit. Other pages in this section provide more detail about the role of different therapists and how they can help your child recover.

What has happened?

Like adults, it is not uncommon for seriously injured children to have no memory/limited memory of the events leading up to their injuries or their initial treatment. This may include being taken to a local hospital before being transferred to a major trauma centre, or being brought straight to a major trauma centre by land or air ambulance.

Initial treatment can include:

  • scans such as a CT (computerised tomography) scan, an MRI (magnetic resonance imaging) scan, or an x-ray
  • medicines to help your child stop bleeding, to control pain, to help your child breathe or to reduce the risk of infection
  • surgery to stop the bleeding, remove any foreign objects from your child’s body, or fix any damaged organs or bones.

Children who have been unconscious or unable to see, hear or understand clearly at the time, may not remember these details. This is normal and a nurse or doctor can help by providing information about what has happened during that time.

How long will my child be in hospital?

Every child is different and it may be necessary for some patients to be kept unconscious while their bodies heal. If this is the case, staff can explain your child’s injury to you and your family, and can also discuss any necessary treatment and the likely length of stay. Once your child is fully conscious, staff will help you to explain what happened during their period of unconsciousness/memory loss.

What happens next?

If your child has been admitted to a major trauma centre, they will often be transferred to a hospital closer to their home after a period of treatment. If he/she is not well enough to go directly home, they will be transferred to your nearest appropriate hospital or to a local rehabilitation service. Clear information about your treatment and ongoing requirements should be passed on to the medical and therapy teams at the trauma unit or rehabilitation service before the child is transferred. This will include a medical discharge letter as well as a rehabilitation prescription before leaving the major trauma centre. The rehabilitation prescription sets out what therapies and other treatments are needed to help your child recover from their injuries. This will be available to other healthcare professionals providing ongoing care after you have left the hospital.

Rehabilitation is a process of assessment, treatment, management and ongoing evaluation to support your child to achieve their maximum potential for physical, cognitive and psychological function, participation in society and quality of living.

Who will care for my child?

Paediatric trauma teams have expertise in all aspects of trauma care. A hospital team at a major trauma centre can include:

  •  Paediatric surgeons: These are highly trained doctors who will manage your child’s injuries. This may involve taking them to the operating theatre to undergo surgery. Some injuries can be managed without surgery.
  • Specialist paediatric doctors: Your child may need medical input from other specialist doctors, such as intensive care, neurology, neurosurgery, orthopaedics, maxillo facial, plastic surgeons and opthalmologists. Your child’s doctors will liaise closely and keep you updated on their individual input, and may also see your child in a follow up clinic after they are discharged.
  •  Major trauma nurse coordinator: The major trauma nurse coordinator oversees the entire pathway of your care during your time in the major trauma centre. They will see you and your child soon after their injury and will work with all of the other healthcare professionals to ensure that you receive seamless care.
  • Clinical nurse specialist: If your child has an injury that involves a specific medical team involvement (such as neurology) you may have a clinical nurse specialist who will work closely alongside the major trauma nurse coordinator. Your child’s clinical nurse specialist will also be able to provide you and your family with injury specific information and support, and may see you in a follow up clinic once your child has been discharged.
  •  Clinical psychologists: Psychologists work in a range of settings with adults and children who are experiencing mental and physical health problems. The psychologist can work with you and your child to try to reduce distress and enhance wellbeing. He/she can provide information and support to help you to make sense of how you are feeling and help you work through any problems you are experiencing.
  • Clinical psychiatrist: Your child and family is likely to be seen by a clinical psychiatrist who is a doctor that specializes in assessing, treating and managing mental disorders and syndromes, which can be common following a traumatic event. They may also look at prescribing medication to help with any on going issues.
  • The Acute Paediatric Therapies Team provides specialist intervention to children and families needing support following a traumatic injury. They work closely with each other and the nurses, doctors, community teams to optimise recovery and ensure a safe, timely and supported discharge from hospital to their home or external rehabilitation services.
  • Occupational Therapy services help children to carry out everyday activities such as playing, getting dressed and going to school, as safely and as independently as possible.  
  • Physiotherapy services aim to assess and promote a child's physical ability. This will include assessment of muscle tone, muscle strength and length and may include assessment of balance and coordination.  
  • Dietetics services aim to assess and ensure a child’s changing nutritional needs are continually being met. This may include use of different diets, plans and routes of nutrition to support your child’s growth, weight and nutritional wellbeing.  
  • Speech and Language Therapy services provide diagnostic intervention to promote safe and enjoyable eating, drinking and swallowing and effective communication skills with their family, friends and staff. 
  • Play Teams provide specialist preparation, distraction for children to facilitate child-centred care before, during and after medical procedures and support children and their family to engage in play activities to encourage wellbeing and happiness during their stay.
  • Chaplaincy/ spiritual care. Many people value the opportunity to talk to someone about what is happening to them and how they feel about the changes they are facing. UK major trauma centres often offer Christian, Muslim and Jewish chaplains, as well as a range of volunteers from other faith traditions.
  • Clinical pharmacists: Clinical pharmacy teams consist of pharmacists and pharmacy technicians. They provide advice to those prescribing medicines throughout the hospital to ensure that patients receive the best medicines for their care. They also provide advice to patients on how to best use their medicines. All patients have their medication reviewed and adjusted according to their needs and all wards are visited daily.
  • Pain service: If your child requires help with their pain control they can be referred to the pain service. This is a team of specialist nurses and anaesthetists who can advise on how best to optimise the effects of painkillers and who can suggest other ways to enhance pain control.

Common parent reactions to child injury

A child's injury is a highly stressful time for parents, who can find coping difficult. Click here to read a piece about common parent reactions, written by a clinicial psychologist with extensive experience in a major UK children's hospital.