Caring for teenagers after major trauma

Automatic transcript, lightly edited for readability. It may contain errors, so check it against the video before quoting.

So I had an interesting debate today with one of my colleagues from Imperial College London where we talked about where should young children, where should young adults, say 14, 16, 17, where should they go after trauma. Now, of course, the debate is whether they should be nursed in adult critical care, in adult services, or in paediatric critical care and paediatric services. And we have a strong argument from the adult side to say they see more numbers. They're more equipped about dealing with this kind of age group.

But my argument has been we're not talking about an injury here, because injury takes place. You get resuscitated. You get the operative treatment. But the question is where do these children go after surgery? Because it's not only about the operative measures. It's about who takes care of their vulnerabilities. We've got a 16, 17 year old who've got a stab injury. They've got safeguarding concerns. They've got families to take care of.

And very importantly, I argue that a 16 year old just doesn't turn on the adult physiology on the 16th birthday. They grow. They are still a child at heart and we need to cater not only to their health needs, we need to cater for their psychosocial needs. We need to make sure they integrate well into their school. They go back to sports.

So it's the whole journey of a patient, of a teenager, which starts yes with a trauma call, yes with the surgeon, but it should have a holistic care, a holistic approach from the medical side, the psychosocial side, the safeguarding side, and work with the family as a team. So I think personally that there should be an integrated approach. You bring the expertise to the patient, to the teenager, rather than take the teenager to the adult service and leave him all alone.