Paediatricians tend to forget that injury is the most common cause of death in school age children, responsible for just over a third of deaths in this age group. Even in children aged 1 to 4 years, nearly a quarter of deaths are traumatic in origin. In the past decade there has been increasing interest in the prevention and epidemiology of childhood injuries with advances in initial resuscitation and treatment, which depend on a basic understanding of the underlying pathophysiological processes.

Some deaths from trauma result from overwhelming damage and are inevitable. Children with less severe injuries may deteriorate quite rapidly and develop …