Injured, ill children treated at U.S. military hospital in Iraq

September 04, 2006

Based on the experience of Air Force personnel at an expeditionary military hospital in Iraq, military hospitals should be prepared with the proper staff, training and equipment to treat injured and noninjured children who require medical care, according to a report in the September issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Military hospitals are likely to encounter injured children as wars move away from the battlefield and into civilian territories, according to background information in the article. Children sometimes serve as soldiers or are used as human shields. In addition, because war disrupts medical facilities in the affected area, children with other injuries or illnesses may seek medical care at U.S. military hospitals as well. When U.S. and coalition forces entered Iraq in 2003, Iraqi civilian hospitals were already understaffed and lacked the supplies and infrastructure needed to effectively care for citizens. From early in the conflict, medical care was offered to injured civilians in cases of severe injury, and hospital commanders could approve care for children with medical needs that could not be handled by the Iraqi system.

Lt. Col. Christopher P. Coppola, U.S.A.F., M.C., and colleagues at the Lackland Air Force Base, Texas, reported on the children treated at one level III (medical facility in a combat area) hospital in Balad, Iraq, from January 2004 to May 2005. The 332nd Air Force Theater Hospital is approximately 40 miles north of Baghdad and consists of a series of tents with concrete floors, linked by a corridor. The facility has a staff of 420 and can accommodate up to 24 intensive care unit beds and 80 additional beds; up to six surgeries can be performed at once.

"Our primary mission as a level III hospital was to provide evaluation, resuscitation and surgical care to combat-injured troops," the authors write. "However, our facility experienced 'mission creep' because 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."
-end-
(Arch Pediatr Adolesc Med. 2006;160:972-976. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

The JAMA Network Journals

Related Children Articles from Brightsurf:

Black and Hispanic children in the US have more severe eczema than white children
A presentation at this year's virtual American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting reveals the disparities that exist for Black and Hispanic children when it comes to Atopic Dermatitis (AD), commonly known as eczema.

Black children with cancer three times less likely to receive proton radiotherapy than White children
A retrospective analysis led by investigators from Brigham and Women's Hospital has found racial disparities in the use of the therapy for patients enrolled in trials.

The Lancet Child & Adolescent Health: First Europe-wide study of children confirms COVID-19 predominately causes mild disease in children and fatalities are very rare
Children with COVID-19 generally experience a mild disease and fatalities are very rare, according to a study of 582 patients from across Europe published today in The Lancet Child & Adolescent Health journal.

Children not immune to coronavirus; new study from pandemic epicenter describes severe COVID-19 response in children
- While most children infected with the novel coronavirus have mild symptoms, a subset requires hospitalization and a small number require intensive care.

How many children is enough?
Most Russians would like to have two children: a boy and a girl.

Preterm children have similar temperament to children who were institutionally deprived
A child's temperament is affected by the early stages of their life.

Only-children more likely to be obese than children with siblings
Families with multiple children tend to make more healthy eating decisions than families with a single child.

Children living in countryside outperform children living in metropolitan area in motor skills
Residential density is related to children's motor skills, engagement in outdoor play and organised sports. that Finnish children living in the countryside spent more time outdoors and had better motor skills than their age peers in the metropolitan area.

Hispanic and black children more likely to miss school due to eczema than white children
In a study that highlights racial disparities in the everyday impact of eczema, new research shows Hispanic and black children are more likely than white children to miss school due to the chronic skin disease.

Children, their parents, and health professionals often underestimate children's higher weight status
More than half of parents underestimated their children's classification as overweight or obese -- children themselves and health professionals also share this misperception, according to new research being presented at this year's European Congress on Obesity (ECO) in Glasgow, UK (April 28-May 1).

Read More: Children News and Children Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.