In late August, the American Academy of Pediatrics (AAP) released a new policy statement, Systems-Based Care of the Injured Child. The AAP begins the policy statement by pointing out that injury is the leading cause of death for children, and a common cause of disability which can lead to life-long behavioral and mental health challenges. A pediatric trauma system should deliver coordinated care for injured children through emergency response, transport, treatment, rehabilitation, and reintegration.

The policy statement is meant to frame the integration of care and optimize outcomes for injured pediatric patients. The AAP points out that the current state of pediatric care lacks cohesion and has notable gaps in pediatric readiness, which leads to less desirable outcomes.

The policy statement includes 10 recommendations and eight action and implementation strategies. There is also provided commentary on special considerations including child abuse, injury trends, disparities in care, recovery from injury, and research and advocacy.

Systems-Based Care of the Injured Child: Policy Statement
Recommendations from the AAP Policy Statement on Systems-Based Care of the Injured Child
  1. The unique needs of injured children and their families should be integrated into trauma systems and disaster planning at the local, state, regional, and national levels.
  2. An integrated public health approach to pediatric injury should address the needs of children across the continuum of care, including injury prevention, prehospital care, emergency and acute hospital care, rehabilitation, and long-term follow-up, to optimize successful reintegration into the community.
  3. Evaluation and management of the injured child begins with EMS clinicians in the field and clinicians in urgent care centers and emergency departments who have education, competency, and proficiency in pediatric readiness at the point of trauma care.
  4. Emergency departments throughout the United States should refer to pediatric readiness guidelines to facilitate appropriate care for all children.
  5. Specialized pediatric trauma centers are essential components of trauma systems and should provide support and guidance to non-pediatric and non-trauma centers as part of their outreach mission.
  6. All members of the health care team across the care continuum must be aware of potential abuse when evaluating injured children including equitable reporting of concerns to the appropriate authorities.
  7. Optimal recovery after injury requires a trauma-informed approach, and the mental health needs of injured children and their families should be supported through screening and the provision of appropriate resources tailored to their needs after injury.
  8. National organizations with a special interest in pediatric trauma should work together to ensure pediatric trauma care is multidisciplinary and collaborative to provide the highest quality of care.
  9. Pediatric trauma care teams should actively work to provide equitable care to all injured children.
  10. Systematic and transparent data collection and data sharing must occur at local, regional and national levels to inform all aspects of trauma care, from injury prevention to research and advocacy.
Action and Implementation Strategies from the 2025 AAP Systems-Based Care of the Injured Child Policy Statement
  1. State and federal institutions should financially support pediatric trauma system development and maintenance, disaster planning, data collection and sharing, research, and education.
  2. Every state or region should identify specialized trauma centers with the resources to care for injured children and establish systems to triage injured children appropriately based on their needs.
  3. Health care systems should actively participate in and cultivate injury-prevention programming to reduce the rate of pediatric injuries.
  4. Prehospital and hospital clinicians should make every effort to stay current in the management of injured children, including the ability to evaluate, stabilize, and transfer acutely injured children. Direct feedback from trauma centers can assist with continued process improvement for prehospital teams and agencies.
  5. Interfacility transfer guidelines and protocols should be in place to facilitate rapid transport of critically injured children to trauma centers that can provide an appropriate level of care. EMS professionals and transport teams with pediatric expertise should be used in the interfacility transport of critically injured children.
  6. Evidence-based protocols for the management of the injured child should be developed for essential aspects of care across the continuum of care. These should be continuously revised to reflect current evidence, with the goal to improve outcomes after injury.
  7. Evidence-based mental health screening tools should be developed for use in the acute setting and in follow-up to aid in the early detection of children at risk for development of posttraumatic stress disorder. Those at risk should be provided resources and/or referral for early intervention by mental health professionals trained in trauma-informed care.
  8. Established performance improvement and quality improvement programs should be established at all centers caring for injured children. Closed loop communication in the form of direct, constructive feedback should be provided by, and to, pediatric trauma centers to allow for continued education and improved pediatric care.

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