Multiple trauma care in childhood - practical and pragmatic summary of the new guideline

Children are not little adults; thus, the algorithms, drugs, and procedures from adult medicine cannot be directly applied to childhood. The proportion of seriously injured children and adolescents under the age of 16 is very low at 3-4% of all seriously injured persons. In this age group, in particular, standardized processes in prehospital care and in the emergency room with subsequent in-hospital treatment, are decisive in terms of overall survival. If we speak of "multiple trauma" in childhood, we continue to assume-contrary to the Berlin definition-multiple injuries of which one or a combination of injuries is potentially life-threatening. The guideline "Multiple trauma care in childhood" comprises a total of 71 guiding principles. Thereof, 16 can be recommended, 37 recommended and 18 strongly recommended aspects were concerted among the 22 representatives of the specialist societies and professional associations. The special features about prehospital care and transport as well as inhospital care in the emergency room are discussed. In particular prehospital airway management, care of severe traumatic brain injuries, anti fibrinolytic, graduated radiological diagnostics according to the ALARA (as low as reasonably achievable) principle, as well as the diagnosis and therapy of thoracic and abdominal trauma are dealt with. In addition to these aspects, it is important for effective emergency room care that employees in both prehospital care and care in the emergency room are regularly allowed to take part in established simulation training.