Trauma is a leading cause of paediatric morbidity and mortality, but is often managed at non-paediatric specialist centres, where limited familiarity with paediatric patient management impacts care quality and outcomes. Telemedicine presents a unique solution to these problems, having the potential to improve patient outcomes by influencing the immediate assessment, management and disposition of injured children. This scoping review aims to detail the use of telemedicine in acute paediatric trauma: when and where it is used, what outcomes have been evaluated and any evidence gaps.
Methodology
We conducted a scoping review to identify primary studies that evaluated the use of telemedicine in paediatric trauma. Five databases were searched for relevant studies published prior to June 2024.
Results
Nine studies were included. Most papers (n = 8) reported on the effect of telehealth on patient treatment decisions and outcomes, including a decrease in mortality (n = 1), impact on patient disposition (n = 1) and change in patient care due to telehealth (n = 1). Clinician satisfaction (n = 3), parent satisfaction (n = 3) and difficulties encountered with telemedicine usage (n = 2) were also explored.
Conclusion
When employed to connect rural mixed emergency departments with paediatric trauma centres, telemedicine has the potential to influence initial management and improve appropriate disposition rates, with demonstrated improvement in care quality and survival rates, as well as improved stakeholder satisfaction. However, there is a need for higher-quality evidence generated through prospective studies to validate the use of telemedicine in paediatric trauma and demonstrate its impact on value-based care provided to children and their support networks.
LiuLVillavicencioFYeungD, et al.National, regional, and global causes of mortality in 5–19-year-olds from 2000 to 2019: a systematic analysis. Lancet Glob Health2022; 10: e337–e347.
2.
KhalilMAlawwaGPintoF, et al.Pediatric mortality at pediatric versus adult trauma centers. J Emerg Trauma Shock2021; 14: 128.
3.
LimJCBorlandMLMiddletonPM, et al.Where are children seen in Australian emergency departments? Implications for research efforts. Emerg Medicine Australasia2021; 33: 631–639.
4.
VarmaSSchinasiDAPonczekJ, et al.A retrospective study of children transferred from general emergency departments to a pediatric emergency department: which transfers are potentially amenable to telemedicine?J Pediatr2021; 230: 126–132.e1.
5.
KerrLKealyBLimD, et al.Rural emergency departments: a systematic review to develop a resource typology relevant to developed countries. Australian J Rural Health2021; 29: 7–20.
6.
ObermeyerZAbujaberSMakarM, et al.Emergency care in 59 low- and middle-income countries: a systematic review. Bull World Health Organ2015; 93: 577–586G.
7.
RimalDHuang FuJHGillettD.Our experience in using telehealth for paediatric plastic surgery in Western Australia. ANZ J Surg2017; 87: 277–281.
8.
HolterJAJeppesenEDehliT, et al.Urban-rural disparities in fatal and non-fatal paediatric injuries after trauma – A national retrospective cohort study. Injury2024; 55: 111968.
9.
MooreLFreireGTurgeonAF, et al.Pediatric vs adult or mixed trauma centers in children admitted to hospitals following trauma: a systematic review and meta-analysis. JAMA Netw Open2023; 6: e2334266.
10.
MitchellRJCurtisKChongS, et al.Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia. Injury2013; 44: 97–103.
11.
KimYGroombridgeCRomeroL, et al.Decision support capabilities of telemedicine in emergency prehospital care. Systematic review. J Med Internet Res2020; 22: e18959.
12.
FitzgeraldMReillySSmitDV, et al.The World Health Organization trauma checklist versus trauma team time-out: a perspective. Emerg Medicine Australasia2019; 31: 882–885.
13.
KilnerESheppardLA. The role of teamwork and communication in the emergency department: a systematic review. Int Emerg Nurs2010; 18: 127–137.
14.
World Health Organization & International Telecommunication Union. National eHealth strategy toolkit, https://iris.who.int/handle/10665/75211 (2012, accessed 21 November 2024).
HeathBSalernoRHopkinsA, et al.Pediatric critical care telemedicine in rural underserved emergency departments*. Pediatr Crit Care Med2009; 10: 588–591.
17.
SaidinejadMBarataIFosterA, et al.The role of telehealth in pediatric emergency care. JACEP Open2023; 4: e12952. Epub ahead of print June 2023.https://doi.org/10.1002/emp2.12952.
18.
TaylorMAKnochelMLProctorSJ, et al.Pediatric trauma telemedicine in a rural state: lessons learned from a 1-year experience. J Pediatr Surg2021; 56: 385–389.
19.
HernandezMHojmanNSadorraC, et al.Pediatric critical care telemedicine program: a single institution review. Telemed J e-Health : Off J Am Telemed Assoc2016; 22: 51–55.
20.
KimJWLameMSzalayL, et al.Telemedicine surge for pediatric patients in response to the COVID-19 pandemic in New York city. Telemed J E Health2021; 27: 1105–1110.
21.
ClarkNMAgoubiLLGibbsS, et al.Impact of tele-triage pathways on short-stay admission after transfer to a regional burn center for acute burn injury. J Am Coll Surg2023; 237: 799–807.
22.
EsberkTDasK. Telemedicine for the management of pediatric burn patients admitted to emergency services. J Telemed Telecare2023; 29: 755–760.
23.
FarookSADavisAKSadiqZ, et al.A retrospective study of the influence of telemedicine in the management of pediatric facial lacerations. Pediatr Emerg Care2013; 29: 912–915.
24.
AbbotSProudmanSBednarzJ, et al.Outcomes of proximal humerus fractures in children: a retrospective cohort study. ANZ J Surg2024; 94: 743–748.
25.
RobinsonPMSimFLatimerM, et al.Paediatric fracture clinic re-design: incorporating a virtual fracture clinic. Injury2017; 48: 2101–2105.
26.
SilvaMDelfosseEMAceves-MartinB, et al.Telehealth: a novel approach for the treatment of nondisplaced pediatric elbow fractures. J Pediatr Orthop B2019; 28: 542–548.
27.
ScurlockCBeckerC. Telemedicine for trauma and emergency: the eICU. Curr Trauma Rep2016; 2: 132–137.
28.
McWilliamsTHendricksJTwiggD, et al.Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings. Burns2016; 42: 1487–1493.
29.
GarciaDIHowardHRCinaRA, et al.Expert outpatient burn care in the home through mobile health technology. J Burn Care Res2018; 39: 680–684.
30.
Caze IiTKnellGPAbtJ, et al.Management and treatment of concussions via tele-concussion in a pediatric setting: methodological approach and descriptive analysis. JMIR Pediatr Parent2020; 3: e19924.
31.
EllisMJNormandHGargaroJ, et al.Current use and future considerations for concussion telemedicine healthcare in Canada. Can J Neurol Sci2023; 50: 257–261.
32.
MitraAVeerakoneRLiK, et al.Telemedicine in paediatric emergency care: a systematic review. J Telemed Telecare2023; 29: 579–590.
33.
MollenCJHenienMJacobsLM, et al.Parent perceptions on transfers to pediatric emergency departments and the role of telemedicine. Pediatr Emerg Care2019; 35: 180–184.
34.
ChaudhryHNadeemSMundiR. How satisfied are patients and surgeons with telemedicine in orthopaedic care during the COVID-19 pandemic? A systematic review and meta-analysis. Clin Orthop Relat Res2021; 479: 47–56.
35.
YangNHDharmarMYooBK, et al.Economic evaluation of pediatric telemedicine consultations to rural emergency departments. Med Decis Making : Int J Soc for Med Decis Making2015; 35: 773–783.
36.
RosenthalJLHaynesSCBonillaB, et al.Enhancing the implementation of the virtual pediatric trauma center using practical, robust, implementation and sustainability model: a mixed-methods study. Telemed Rep2022; 3: 137–148.
37.
Uscher-PinesLMehrotraA. Analysis of teladoc use seems to indicate expanded access to care for patients without prior connection to A provider. Health Aff2014; 33: 258–264.
38.
AngstmanKBRohrerJEAdamsonSC, et al.Impact of e-consults on return visits of primary care patients. Health Care Manag2009; 28: 253–257.
39.
ZeltzerDEinavLRashbaJ, et al.The impact of increased access to telemedicine. J Eur Econ Assoc2024; 22: 712–750.
40.
EkelandAGBowesAFlottorpS. Effectiveness of telemedicine: a systematic review of reviews. Int J Med Inf2010; 79: 736–771.
41.
NouhTShalhoubMAlburakanA, et al.The clinical effectiveness in telemedicine in trauma: a systematic review and meta-analysis. Int J Med Inf2025; 202: 105986.
42.
AlansariANZaazoueeMSNajarS, et al.Telemedicine applications in pediatric emergency surgery and trauma: a systematic review of diagnostic accuracy and clinical effectiveness. Pediatr Surg Int2025; 41: 122. DOI: 10.1007/s00383-025-06023-9.
43.
FreireGCBenoSYancharN, et al.Clinical practice guideline recommendations for pediatric multisystem trauma care: a systematic review. Ann Surg2023; 278: 858–864. https://doi.org/10.1097/SLA.0000000000005966.
44.
TriccoACLillieEZarinW, et al.PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med2018; 169: 467–473.
45.
ArkseyHO’MalleyL. Scoping studies: towards a methodological framework. Int J Soc Res Methodol2005; 8: 19–32.
46.
DharmarMRomanoPSKuppermannN, et al.Impact of critical care telemedicine consultations on children in rural emergency departments. Crit Care Med2013; 41: 2388–2395.
47.
FugokKSlamonNB. The effect of telemedicine on resource utilization and hospital disposition in critically ill pediatric transport patients. Telemedicine e-Health2018; 24: 367–374.
48.
JacksonEMCostabilePMTekesA, et al.Use of telemedicine during interhospital transport of children with operative intracranial hemorrhage*. Pediatr Crit Care Med2018; 19: 1033–1038.
49.
MarcinJPScheppsDEPageKA, et al.The use of telemedicine to provide pediatric critical care consultations to pediatric trauma patients admitted to a remote trauma intensive care unit: a preliminary report. Pediatric Crit Care Med : J Soc Crit Care Med World Federat Pediatr Intensive Crit Care Soc2004; 5: 251–256.
50.
ZorinVILukyanovSA. Telemedicine consultations for children with musculoskeletal injuries: data from the Turner National Medical Research Center of Children’s Orthopedics and Trauma Surgery. Travmatologiya I Ortopediya Rossii2023; 29: 86–93.
51.
ChamberlainJMPatelKMPollackMM. The pediatric risk of hospital admission score: a second-generation severity-of-illness score for pediatric emergency patients. Pediatrics2005; 115: 388–395.
52.
WakeEAtkinsHWillockA, et al.Telehealth in trauma: a scoping review. J Telemed Telecare2022; 28: 412–422.
53.
O’SullivanLDeasyC. O’Sullivan Í. Paediatric major trauma: demographics, management and outcomes at Cork University Hospital. Ir J Med Sci2022; 191: 2343–2350.
54.
DayalPHojmanNMKisseeJL, et al.Impact of telemedicine on severity of illness and outcomes among children transferred from referring emergency departments to a children’s hospital PICU. Pediatr Crit Care Med2016; 17: 516–521.
55.
OdetolaFOMillerWCDavisMM, et al.The relationship between the location of pediatric intensive care unit facilities and child death from trauma: a county-level ecologic study. J Pediatr2005; 147: 74–77.
56.
CopeJGreerDSoundappanSSV, et al.The safety and efficacy of early enteral nutrition after paediatric enterostomy closure - the EPOC study. J Pediatr Surg2024; 59: 701–708.
57.
YangNHDharmarMKuppermannN, et al.Appropriateness of disposition following telemedicine consultations in rural emergency departments. Pediatr Crit Care Med2015; 16: e59–e64.
58.
RingDLeopoldSS. Editorial—measuring satisfaction: can it be done?Clin Orthop Relat Res2015; 473: 3071–3073.
59.
NguyenCKortleverJTPGonzalezAI, et al.Attempts to limit censoring in measures of patient satisfaction. J Pat Exp2020; 7: 1094–1100.
60.
ArdolinoASleatGWillettK. Outcome measurements in major trauma—results of a consensus meeting. Injury2012; 43: 1662–1666.
61.
MartinezRRogersADNumanogluA, et al.The value of WhatsApp communication in paediatric burn care. Burns2018; 44: 947–955.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
