Trauma scoring and pediatric patients: issues and controversies.

In summary, controversy exists as to the use of trauma scoring in pediatrics. No one currently available trauma score is ideal for use with all patients. To address these issues, the impact of major trauma on children must be more clearly defined in relation to the impact of trauma on adults. Areas for ongoing research include analysis of the clinical implications of pediatric differences in response to trauma, comparison of prehospital and ED trauma scoring, and further studies using large samples of reliability and validity of various trauma scores. A trauma score is an adjunct to--not a substitute for--a full and ongoing clinical assessment. When using adult scoring systems with children, it is important to remember that normal values for an adult are not necessarily normal for a child. Recognizing the differences between adults and children is an essential first step in assessing and managing the effects of injury in children.