Error traps and culture of safety in pediatric trauma

Semin Pediatr Surg. 2019 Jun;28(3):183-188. doi: 10.1053/j.sempedsurg.2019.04.022. Epub 2019 Apr 25.


Trauma is the leading cause of morbidity and mortality in the pediatric population. Due to a variety of factors, many pediatric trauma patients are initially evaluated and stabilized at adult hospitals that lack pediatric specific emergency medicine and surgical expertise. While similar to adult patients, the initial evaluation and resuscitation of pediatric patients does differ. Many of these key differences contribute to missed injury and susceptibility to error in the treatment of children. Here, we highlight a variety of differences between pediatric and adult trauma patients and clarify reasoning for these differences. Error traps that are discussed include missed cases of non-accidental trauma, missed blunt cerebrovascular injury, over use of CT (computed tomography) scans with unnecessary radiation exposure, missed small bowel or mesenteric injury, and unrecognized hemodynamic instability.

Keywords: Non-accidental trauma; Pediatric; Trauma.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Carotid Artery Injuries / diagnosis*
  • Child
  • Child Abuse*
  • Child, Preschool
  • Craniocerebral Trauma / diagnosis*
  • Humans
  • Hypovolemia / diagnosis*
  • Infant
  • Intestines / injuries*
  • Medical Errors*
  • Patient Safety*
  • Pediatric Emergency Medicine / methods
  • Pediatric Emergency Medicine / standards*
  • Vertebral Artery / injuries*
  • Wounds, Nonpenetrating / diagnosis*