A 20 year journey in Trauma Care

By Debbie Friedman, Director

Trauma is a leading cause of death and disability in children and teens. Trauma by its very nature is often sudden, life altering, and can be devastating. Rapid access to expert medical, surgical, nursing, rehabilitation and psychosocial trauma care, state of the art equipment, and a well developed efficient and innovative trauma care system is paramount in increasing the chances of a positive outcome. At the MCH, our trauma specialists are frequently faced with the reality of treating children and teens that are in life threatening situations following a traumatic injury.

We take great pride in being a provincially designated Trauma Centre and Neurotrauma Centre of Expertise, and in the 5 inter-professional programs that we have developed over the past twenty years. These include: The Neurotrauma Program which was the first of its kind in Quebec, The Trauma Program, The Burn Trauma Program, The Mild Traumatic Brain Injury / Return to Sports Program with its Concussion Clinic, and our recently expanded Injury Prevention Program. Through the many teams of trauma experts involved in these different programs we provide specialized care to children and teens who have sustained injuries. Some of which include: motor vehicle crashes, falls from heights; injuries incurred while participating in a wide array of sports and recreational activities, burns from hot water or fire, drowning in lakes and pools, poisonings, ingestion of foreign bodies, traumatic amputations from farming equipment, physical and psychological trauma sustained from assault or abuse, and others.

Every year more than 15,000 children and teens are treated in our Emergency Department for a large variety and severity of traumatic injuries. At least 500 of these cases are serious, and require hospitalization and the timely interventions of our many trauma specialists. In addition to our acute care programs we work closely with regional centres and community physicians following hundreds of ambulatory patients annually.

Trauma impacts not only on the patient but their family, friends, and community. MCH Trauma brings together the medical, surgical, nursing, rehabilitation and psychosocial expertise of close to 30 departments and services working together to meet the multi-faceted, complex needs of our children and teens as well as their families. This takes place from the patient’s initial arrival in the ER through the critical care phases, early rehabilitation and recovery stages and eventual transfer to an appropriate rehabilitation centre, community resource or return home.

In addition to our clinical programs here are some of the highlights of our evolution and efforts over the past 2 decades. 

In 2007 we expanded our Injury Prevention Program, an important part of our mandate as a Trauma Centre. It is tragic that 90% of what we see can be prevented. Injury prevention is truly the treatment of choice for trauma. We are extremely pleased with our community out-reach initiatives and look forward to developing many more local, regional, provincial, and Canada-wide partnerships in the future .    

To meet the increasing popularity of organized sports and the importance of timely interventions following a concussion, in 2007 we developed a specialized Concussion Clinic along with a guide for coaches in the form of an innovative Concussion KiT. It was used in our out-reach activities with sporting associations, schools, and summer camps. 

In 2008 we expanded our Trauma research section and have shared our knowledge in numerous initiatives including multi-centre projects, publications in peer reviewed journals, and participation in national and international conferences.

In 2009 we launched a new and award winning Trauma Website (thechildren.com/trauma) and are pleased to be able to offer our users up to date comprehensive information.

Over the years we have given hundreds of interviews on a wide array of trauma topics to local, provincial and national media. Our collaborative relationship with the media, has facilitated our ability to provide timely alerts and diffuse important trauma and injury prevention information to the community.

Clinical and academic teaching is also an important aspect of our mandate. Program members are regularly involved in the education of trainees from a wide variety of healthcare professions. We recently had the opportunity to share our inter-professional Trauma experience with approximately 600 first year McGill students from the faculties of Medicine, Physiotherapy, Dentistry, Nursing, Speech and Language Pathology, and Occupational Therapy.

As I reflect upon the past 20 years I feel especially proud of our leadership role in paediatric and adolescent trauma, the teamwork and tremendous inter-professional collaboration that has taken place, the growth and development of our different programs, the many important professional partnerships and networks developed, and the many meaningful friendships that have emerged amongst program members.

Happy 20th Anniversary MCH Trauma !

Wishing everyone a happy, healthy and trauma free 2010.