Els van Meijel

10 Chapter 1 | General introduction Accidental injury Accidents are a major cause of injury in children and adolescents 1 (Brosbe, Hoefling, & Faust, 2011; Kassam-Adams, Marsac, Hildenbrand, & Winston, 2013). Accidental injury can have great impact on the lives of children and their parents. The accident itself, being transported in the ambulance, the injury, the pain, medical procedures and hospitalization – all can be frightening and potentially traumatic (Kahana, Feeny, Youngstrom, & Drotar, 2006; Price, Kassam-Adams, Alderfer, Christofferson, & Kazak, 2016). Furthermore, children and parents may be uncertain about the immediate and long-term outcome and consequences. After a serious accident, children are often treated in the trauma resuscitation room (trauma room) of the emergency department. In a trauma room, a multi-disciplinary teamof medical specialists and nurses provides the initial assessment and treatment of trauma patients. Children are referred to the trauma room in cases with a high-energy trauma mechanism, involving a risk of severe and/or potentially life-threatening injuries. High-energy trauma mechanism refers to injuries associated with high-energy impact such as a fall from height (> 10 ft or 2 to 3 times the height of the child), a high-risk automobile crash or a pedestrian/bicycle vs. automobile collision (American College of Surgeons, 2012). The Netherlands has eleven level 1 trauma centers, which are located in all regions of the country. A level 1 trauma center is staffed and equipped to provide care for patients with one or more major traumatic injuries. Facts and figures Generally, four categories of accidents are used in reports of accidents: sports-related, traffic-related, industrial and private. The last category involves all accidents besides sports, traffic and industrial accidents. In the Netherlands, approximately 123,000 children (aged 8–18 2 ; 43% girls, 57% boys) per year are injured in an accident and are subsequently treated in the emergency department of a hospital (VeiligheidNL, 2018). In traffic-related accidents 73% of the children were riding a bike and 17% a moped or a scooter. The majority of the children (54%) were individually involved in 1 For reasons of readability, both groups are generally referred to as ‘children’ in this thesis. 2 Since the main focus of this thesis is on children aged 8-18, only information on children in this age category is presented here.