title: Paediatric admissions to the British military hospital at Camp Bastion, Afghanistan.
abstract: BACKGROUND
  International humanitarian law requires emergency medical support for both military personnel and civilians, including children. Here we present a detailed review of paediatric admissions with the pattern of injury and the resources they consume.
  
  
  METHODS
  All paediatric admissions to the hospital at Camp Bastion between 1 January and 29 April 2011 were analysed prospectively. Data collected included time and date of admission, patient age and weight, mechanism of injury, extent of wounding, treatment, length of hospital stay and discharge destination.
  
  
  RESULTS
  Eighty-five children (65 boys and 17 girls, median age: 8 years, median weight: 20 kg) were admitted. In 63% of cases the indication for admission was battle related trauma and in 31% non-battle trauma. Of the blast injuries, 51% were due to improvised explosive devices. Non-battle emergencies were mainly due to domestic burns (46%) and road traffic accidents (29%). The most affected anatomical area was the extremities (44% of injuries). Over 30% of patients had critical injuries. Operative intervention was required in 74% of cases. The median time to theatre for all patients was 52 minutes; 3 patients with critical injuries went straight to theatre in a median of 7 minutes. A blood transfusion was required in 27 patients; 6 patients needed a massive transfusion. Computed tomography was performed on 62% of all trauma admissions and 40% of patients went to the intensive care unit. The mean length of stay was 2 days (range: 1-26 days) and there were 7 deaths.
  
  
  CONCLUSIONS
  Paediatric admissions make up a small but significant part of admissions to the hospital at Camp Bastion. The proportion of serious injuries is very high in comparison with admissions to a UK paediatric emergency department. The concentration of major injuries means that lessons learnt in terms of teamwork, the speed of transfer to theatre and massive transfusion protocols could be applied to UK paediatric practice.
authors.affiliation: UK Medical Treatment Facility, Role 3 Hospital, Camp Bastion, Afghanistan. surenarul@doctors.org.uk
authors.forename: G S
authors.initials: GS
authors.lastname: Arul
authors.forename: J
authors.initials: J
authors.lastname: Reynolds
authors.forename: S
authors.initials: S
authors.lastname: DiRusso
authors.forename: A
authors.initials: A
authors.lastname: Scott
authors.forename: S
authors.initials: S
authors.lastname: Bree
authors.forename: P
authors.initials: P
authors.lastname: Templeton
authors.forename: M J
authors.initials: MJ
authors.lastname: Midwinter
mesh_terms: D000293:Adolescent; D055826:Afghan Campaign 2001-; D000346:Afghanistan / Q000453:epidemiology; D017677:Age Distribution; D001753:Blast Injuries / Q000453:epidemiology / Q000628:therapy; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002056:Burns / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000628:therapy