What should be the core components of a national paediatric trauma system? Trauma centres have been established throughout the world because of their clear impact on outcome. Currently, in the USA there is no standardisation and it is not clear what the current paediatric capabilities are, from state to state. Without standardisation what should be the measures of effectiveness? Fallat M et al (JAMA Surg 2022. doi:10.1001/jamasurg.2022.4303) have aimed to develop objective measures of paediatric trauma system capability with the hypothesis that there is significant variation in capabilities between states, and they aimed to provide a contemporary report on the status …