Major finding: One in four children who suffer a major traumatic injury still do not receive care at pediatric trauma centers, where outcomes typically surpass those seen in adult facilities. This conclusion comes from a five-year study (2016–2021) covering nine Canadian provinces and published in CMAJ (Canadian Medical Association Journal). The authors advocate evidence-based approaches to enhance care for this vulnerable age group.
Dr. Lynne Moore, a professor in the Department of Social and Preventive Medicine at Université Laval, along with colleagues, emphasizes the urgent need to improve access to pediatric trauma centers in Canada. Since most severely injured children first arrive at non-pediatric hospitals, the most effective fixes involve strengthening decision-support in prehospital settings and at non-pediatric hospitals, rather than building new infrastructure.
In the study, 3,007 children with major trauma were admitted to acute-care hospitals across the provinces. Of these, 2,335 children (77%) were either transported directly to a pediatric trauma center (879, 29%) or transferred there (1,456, 48%). Pediatric trauma centers provide specialized care tailored to the unique physical and psychological needs of children and their families.
Access to pediatric trauma centers varies by region. Alberta and Manitoba show relatively higher access, while Ontario, British Columbia, Saskatchewan, and the Atlantic provinces exhibit lower access.
The researchers recommend that provincial trauma systems adopt concrete, evidence-based strategies to boost pediatric access. Examples include:
- A standardized prehospital triage tool adapted specifically for pediatric patients
- Pediatric readiness assessments for nonpediatric hospitals
- Teleconsultation pathways linking referring hospitals with pediatric centers
The authors conclude that immediately applying these strategies, paired with targeted research and national data coordination, could save lives and promote more equitable trauma care for Canadian children, regardless of where they live.
Source:
Lapierre, A., et al. (2025). Access to pediatric trauma centres in Canada: a population-based retrospective cohort study. Canadian Medical Association Journal. doi: 10.1503/cmaj.250625.
https://www.cmaj.ca/content/197/43/E1472
