• accident
• trauma
• injury
• prevention

Trauma prevention is a neglected area from the point of view of coordinated input by paediatricians at local level and to an extent at the Royal College of Paediatrics and Child Health (RCPCH) level. This oversight is surprising given that injury to children is associated with considerable morbidity and mortality. Part of the difficulty generating interest in trauma prevention may lie in the relatively intangible benefits of reducing injury, but nonetheless every paediatrician should consider it within their remit to take any opportunity to reduce accidents which account for over one third of all deaths up to19 years of age. Injury prevention schemes can be cost effective provided they are well directed with achievable goals.¹

Effective injury prevention depends on a combination of three areas of implementation: education, alteration of environmental hazard, and the enforcement of safety legislation. Paediatricians can be involved in improving all the elements of injury prevention: primary prevention (prevention of the accident; for example, using safe materials in playgrounds²); secondary prevention (reducing the effects from the accident; for example, promoting the wearing of bicycle helmets³); and tertiary prevention (diminishing the consequences of the event by the effectiveness of the emergency services provided after the accident). The latter aim can be achieved by improving resuscitation training for dealing with critically ill children by teaching courses such as Paediatric Advanced Life Support (PALS),⁴ Advanced Paediatric Life Support (APLS),⁵ the Advanced Trauma Life Support course (ATLS),⁶ and Prehospital Paediatric Life Support Courses.⁷

The aim of this leading article is to examine the scale of the problem, to show what government strategies have been developed, what resources are available, and how paediatricians at local and at RCPCH level help reduce the morbidity and mortality associated with injury.