Pediatric Surgical Care During Humanitarian and Disaster Relief Missions

Surgeons participating in humanitarian or disaster relief missions should expect trauma patients. Care follows established Advanced Trauma Life Support guidelines but may be impacted by available resources. This review provides treatment principles for the care of traumatically injured children in austere environments. Appropriate triage of patients is paramount in a resource-limited environment. Respiratory failure is a leading cause of cardiac arrest in children, airway management is paramount. Intraosseous access can be lifesaving in a child with difficult intravenous access; preferably placed in the proximal tibia. Resuscitation has transitioned to early use of blood products with improved survival. Malnutrition should be considered in all children. Transition of care discussions should begin during mission planning. Surgeons should be prepared to manage traumatically injured children while involved in humanitarian missions. Recognition of key differences in the management of children can assist with preparation and improve outcomes.