Episode 17: Informed Pediatric Trauma Care: The Compendium

Brought to you by The National Association of EMS Physicians (NAEMSP) and Missouri Emergency Medical Services for Children (MO-EMSC).

Hosts: Dr. Joelle Donofrio-Odmann and Dr. Joseph Finney

Website: https://sites.libsyn.com/414020 

Guest Experts:

Mark Cicero, MD

John Lyng, MD

Episode Summary:
In this episode, we explore the latest NAEMSP Prehospital Trauma Compendium on Pediatric Severe and Inflicted Trauma, published in Prehospital Emergency Care (2025). Joined by pediatric EMS and trauma experts, we discuss how Emergency Medical Services (EMS) clinicians can improve outcomes for children through evidence-based assessment, early recognition of inflicted injuries, and thoughtful implementation of trauma care protocols.

Listeners will learn how unique pediatric physiology—from airway structure and head-to-body ratio to compensatory shock mechanisms—shapes both injury patterns and treatment priorities in the field. We highlight the use of tools such as the Shock Index Pediatric Age-Adjusted (SIPA) and simplified neurologic assessments (GCS-M, AVPU) to identify high-risk patients early.

The discussion emphasizes critical prehospital priorities: preventing hypoxia and hypotension in children with traumatic brain injury, using crystalloids judiciously, expanding access to prehospital blood transfusion, and ensuring rapid transport to pediatric trauma centers when indicated.

We also address inflicted trauma recognition, including sentinel bruising patterns, mechanisms inconsistent with developmental ability, and the challenges of detection in children with chronic or developmental comorbidities. The conversation underscores the importance of ongoing EMS training, simulation, and the role of Pediatric Emergency Care Coordinators (PECCs) in sustaining readiness across systems.

Through case discussion and review of the Compendium's recommendations, this episode reinforces a central message: prehospital providers are a critical first link in the chain of survival for injured children. From field assessment to destination decisions, every action can profoundly shape outcomes.

Key Takeaways:

• Recognize the physiologic and anatomic nuances that make pediatric trauma unique.

• Use SIPA and simplified GCS assessments to identify severe injury early.

• Prioritize oxygenation, blood pressure, and temperature control to prevent secondary injury.

• Identify and report patterns concerning for inflicted injury.

• Partner with regional systems to ensure appropriate pediatric trauma triage and interfacility transfer.

• Integrate simulation, case review, and continuous pediatric-specific education into EMS training programs.

Reference:
Cicero MX, Adelgais K, Funaro MC, et al. Prehospital Trauma Compendium: Pediatric Severe and Inflicted Trauma – A Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care. 2025; DOI: 10.1080/10903127.2025.2457141

Link to FULL Compendium

https://naemsp.org/position-statement/prehospital-trauma-compendium-management-of-geriatric-trauma-patients-a-position-statement-and-resource-document-of-naemsp/