Children’s Hospital Boston’s Trauma Program cares for more injured children than almost any other hospital in the country. Nearly 70 percent of injured children admitted to any hospital in Boston come to Children’s, and in 2009, the hospital reached a milestone by admitting more than 1,200 injury patients for the year. The program continues to grow as it adopts the newest and most efficient trauma care practices.
The Trauma Program has connections with all hospital departments in order to provide the expertise needed to treat the different aspects of any injury. The core team includes specialists from Surgery, Orthopedic Surgery, Neurosurgery, Emergency Medicine, Critical Care Medicine and Anesthesiology. All of these specialists are prepared to care for any injured patient, starting from the Emergency Department (ED) through their return home and long-term follow-up.
The Trauma Program also performs community outreach and injury prevention. Its clinicians provide pediatric-specific education to hospitals and ambulance personnel in the region, as well as provide instruction and safety materials for families.
The Trauma Program treats children with any number of injuries, ranging from minor to the most severe. Each year, hundreds of patients with fractures are admitted to the hospital and hundreds more are treated in the ED. In the past 15 years, Children’s has excelled in the non-operative treatment of ruptured spleens and other solid organs, including the liver, kidneys and pancreas. Out of 41 pediatric hospitals nationwide, Children’s treats the second highest volume of splenic injuries per year and is the most cost- effective. Non-operative treatment of such injuries proves to be less harmful to children.
Director of the Trauma Program, David P. Mooney, MD, MPH, and his team conduct research on the practices of pediatric trauma care in hospitals. Analyses of data on injury treatment, diagnostics and patient follow-up help the Trauma Program fine-tune its own practices in order to maximize effectiveness and minimize harm to injured children. One important adaptation is the elimination of unnecessary imaging tests for injuries to solid organs, which cuts down on radiation exposure. Another guideline has eliminated the use of potentially harmful CT scanning when screening for a cervical spine injury.
This evidence-based approach to trauma care has led to the program’s proficiency in treating solid organ injuries and will continue to inform its approaches to treating other conditions, such as brain injuries. As they continue to adopt the best practices to reduce both costs and recovery time for patients, the Trauma Program staff is happy to share these guidelines with other trauma centers nationally and internationally.
Analysis of the ratio of injury-related deaths to emergency admissions has led to a rewrite of the Pediatric Injury Pyramid, which can have implications for policy, and resources dedicated to emergency treatment of children. The Trauma Program also collaborates with other departments at Children’s to study injury-related conditions. One example is collaboration with the Department of Psychiatry to study the development and possible prevention of post-traumatic stress disorder associated with injuries.
Trauma Program members are working to define the science of injury prevention. Community liaison Taranjeev Walia, BA, recently completed an injury risk assessment study, for which she visited the homes of children from under-served, at-risk communities.
David P. Mooney, MD, MPH
Director, Trauma Program
Maria McMahon, RN, MSN, CCRN
Manager, Trauma Program
Melissa Twomey, MS, RN
regional trauma clinical nurse specialist
trauma registrar/administrative associate
Barbara DiGirolamo, MEd
Make a referral: 866-771-5437 (toll free) or 617-355-2170
Injury prevention information: 617-919-3068 or 617-919-3071