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Military Hospitals Need To Be Prepared To Treat Children

of the presence of injured civilians, including children. Children additionally had dehydration and malnutrition, which contribute to increased mortality. After Jan. 1, 2005, a pediatric surgeon was available and a broader range of non-traumatic conditions were treated in children."

During the time period studied, 85 children with an average age of 8 years (age range one day to 17 years) were evaluated and treated at the hospital, accounting for 5.2 percent of all patients and 18 percent of treated Iraqi civilians. Forty-eight (56 percent) of the children were treated for traumatic injury, including 25 (52 percent) with a fragmentation wound, such as that inflicted by improvised explosive devices, mines or blasts. Of the children with injuries, 18 (38 percent) had wounds in the leg, 11 (23 percent) in the head, eight (17 percent) in the arm, eight in the abdomen and three (6 percent) in the chest. A total of 134 operations were performed on 63 children (74 percent of the total); each of the children had an average of 2.1 procedures. Five children died--two from burns, two from infection and one from complications following a traumatic head injury and transfer to a civilian facility.

The experience illuminates several key points regarding caring for children in a war zone, the authors conclude. Hospitals near battlefields should expect to treat civilians, including children. These children are likely to have fragmentation injuries, which are generally contaminated and likely to become infected, requiring multiple procedures. "Local health resources may be so disrupted that children cannot be safely discharged until they are well enough to survive under the care of their families," they continue. "To provide adequate care for children during war, expeditionary medical hospitals must prepare for them by providing the proper personnel, training and equipment."

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