TY - JOUR T1 - Highlights from this issue JF - Emergency Medicine Journal JO - Emerg Med J SP - 561 LP - 561 DO - 10.1136/emermed-2017-207098 VL - 34 IS - 9 AU - Ellen J Weber Y1 - 2017/09/01 UR - http://emj.bmj.com/content/34/9/561.abstract N2 - This month’s Editor’s Choice, widely reported in the UK and US press, asks the question: when is a trauma victim not treated as a trauma victim? Answer: when they don’t arrive by ambulance. Analysing data on paediatric trauma between 2012 and 2015 from the UK Trauma Audit and Research Network, Davies et al discovered that only 25% of children suspected of being victims of child abuse arrive to EDs by ambulance, compared with 44% of those with accidental injury. The suspected abuse victims were largely infants, average age of 4 months, while the mean age of victims of accidental injury was 7 years. Suspected abuse victims had a higher injury severity score (ISS), yet they reached trauma centres on average 8.2 hours later than those with accidental injury. Mortality among suspected child abuse victims was more than double. In these situations, we cannot rely on the prehospital care system to start the trauma process going: when a parent brings in a traumatised baby, a high index of suspicion and then swift activation of the trauma network is needed.Quality measures … ER -