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Italian hospitals show high protocol adherence but limited availability of senior pediatric surgeons on callSurvey reveals current standards for pediatric polytrauma care in Italy

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Key Takeaway
Note that only 44% of surveyed Italian institutions have a senior pediatric surgeon on call despite high protocol rates.

This guideline is based on a survey of 52 Italian healthcare institutions to assess the current infrastructure and national standards for managing pediatric polytrauma. The scope includes evaluating dedicated emergency departments, specialist availability, multidisciplinary teams, and internal protocols across both pediatric-specific and hybrid hospitals.

Key findings indicate that while 89% of institutions have a dedicated pediatric emergency department and 94% utilize internal management protocols, only 44% have a senior pediatric surgeon on call. Additionally, 72% of centers reported having a multidisciplinary trauma team. High-volume centers were associated with a higher annual incidence of polytrauma compared to low-volume centers. No significant differences in the number of second-level emergency departments or imaging modalities were found between center types.

The authors note a lack of standardized, evidence-based guidelines for pediatric polytrauma management within the current system. These findings suggest that while basic infrastructure is common, specialized personnel availability remains inconsistent. The results highlight specific gaps in standardization and specialized training for pediatric polytrauma care in Italy.

When a child suffers a severe, multi-organ injury known as polytrauma, every second counts. A new survey of 52 healthcare institutions in Italy mapped out the current landscape of care to see how prepared hospitals are to handle these critical cases.

The findings show a mix of strengths and gaps. While 89% of hospitals have dedicated pediatric emergency departments and 94% have internal management protocols, only 44% have a senior pediatric surgeon available on call. Most facilities were hybrid centers rather than dedicated children's hospitals, yet the study found no significant differences in basic infrastructure like imaging or trauma teams between high-volume and low-volume centers.

While the infrastructure is largely consistent across different types of centers, the survey highlights a need for more standardized, evidence-based guidelines. Because this was a descriptive survey of existing facilities rather than a clinical trial, it identifies where training and specialized resources can be improved to ensure every child receives consistent care regardless of which hospital they enter.

What this means for you:
Most Italian hospitals have trauma protocols, but fewer than half have a senior pediatric surgeon on call.

Common questions

What kind of resources are available for children with severe injuries?

The survey found that 89% of the 52 institutions had a dedicated pediatric emergency department and 94% had internal protocols for managing polytrauma. Additionally, 72% of these centers featured multidisciplinary trauma teams to handle complex cases.

Is there a difference in care between large and small hospitals?

The study found no significant differences in the number of emergency departments, availability of surgeons, or trauma teams between high-volume and low-volume centers. However, high-volume centers did report a higher annual incidence of polytrauma cases.

Are there enough specialists available for these cases?

While most hospitals have the necessary infrastructure, only 44% of the institutions surveyed had a senior pediatric surgeon on call. This highlights a specific gap in specialist availability despite having standard emergency protocols.

Study Details

Study typeGuideline
EvidenceLevel 5
PublishedJun 2026
View Original Abstract ↓
IntroductionPolytrauma is defined by the presence of multiple traumatic injuries and poses a significant global health concern due to its associated morbidity. Clear guidelines or recommendations for the medical or surgical management of pediatric polytrauma patients are currently lacking.AimsNational Survey of the Management of Paediatric Polytrauma was conducted to clarify and delineate the current national standards in the care paediatric polytrauma patients.Material and methodsWe conducted a survey among senior physicians from the Italian Society of Pediatric Surgery and the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care. The survey focused on the management of pediatric polytrauma and compared practices between pediatric and hybrid hospitals, as well as between high- and low-volume centers.ResultsA national survey of 52 institutions revealed that 33% were paediatric hospitals and 67% were hybrid institutions treating adult patients. We found that 89% of the institutions had a dedicated paediatric emergency department, and 44% had a senior paediatric surgeon on call. Most hospitals had a dedicated paediatric intensive care unit, 72% had a multidisciplinary trauma team, and 94% had an internal protocol for paediatric polytrauma management. We found no significant differences in the number of second-level paediatric emergency departments, availability of paediatric surgeons, multidisciplinary trauma teams, or imaging modalities. High-volume centres had a higher annual incidence of polytrauma than low-volume centres.ConclusionThe study provides important insights into the current state of paediatric polytrauma management in the Italian healthcare system. The study emphasised the crucial need for standardisation, specialised training, and the development of evidence-based guidelines. The proposed national trauma registry will be instrumental in facilitating this process and improving the quality of care for paediatric polytrauma patients in Italy. Further research examining the effect of volume, training, and guideline implementation on patient outcomes will significantly enhance this field.
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