• Kate Curtis, Belinda Kennedy, Mary K Lam, Rebecca J Mitchell, Deborah Black, Brian Burns, Allan Loudfoot, Gary Tall, Michael Dinh, Clare Beech, and HollandAndrew J AAJAThe Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia..
• Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, MO2 88 Mallett St, NSW 2006, Australia.
• Injury. 2020 Nov 1; 51 (11): 2581-2587.

BackgroundInjury is the leading cause of childhood death and disability in Australia. Prehospital emergency services in New South Wales (NSW) are provided by NSW Ambulance. The incidence, pre-hospital care provided and outcomes of children suffering major injury in NSW has not previously been described.MethodsThis retrospective study was conducted between July 2015 and September 2016 and included children <16 years with an injury severity score (ISS) >9, or requiring intensive care admission, or deceased following injury and treated in NSW. Children were identified through the three NSW Paediatric Trauma Centres, the NSW Trauma Registry, NSW Medical Retrieval Registry (AirMaestro, Avinet, Australia).ResultsThere were 359 majorly injured children treated by NSW-based emergency service providers, the majority were male (73.3%) with a mean (SD) age of 8.0 (5.2) years. The median (IQR) injury severity score (ISS) for those transported via NSW emergency medical services was 10 (9-17), with almost half (44.1%) treated prehospital having an ISS >12. The most common documented interventions were intravenous access (44.1%) and oxygen therapy (39.6%). Intubation and chest decompression were recorded in 15.3% and 3.1% of cases respectively. The calculated median (IQR) transport charges for NSW Emergency Services was AUD $942 ($841.3-$1184.6).ConclusionCritical interventions are performed infrequently in children with major injuries in the pre-hospital environment. The monitoring of the incidence and success rates for staff performing these interventions is not readily available from all prehospital emergency medical services operating in NSW. The capacity and processes to monitor and audit all critical interventions in the paediatric population should be resourced and clearly defined.Copyright © 2020. Published by Elsevier Ltd.

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