Promoting Optimal Pediatric Readiness at US Trauma Centers: Understanding and Addressing Barriers

Children treated at facilities prepared to provide emergency pediatric care have improved outcomes, but access to pediatric-ready care remains inconsistent. A multidisciplinary spotlight session at the 2026 American College of Surgeons Committee on Trauma Annual Meeting examined barriers to pediatric readiness across US trauma systems and practical strategies to address them. Participants identified limited dedicated personnel, financial and equipment constraints, fragmented regional coordination, inconsistent requirements, and barriers to completing and acting on pediatric readiness assessments, particularly among rural, resource-limited, and non-verified facilities. Proposed strategies emphasized regional shared accountability, including engagement of higher-level trauma centers and regional pediatric emergency care coordinators to support smaller facilities, targeted outreach through existing trauma networks, shared or rotated resources, improved access to guidelines and tools, and local champions to facilitate readiness assessments. Although these recommendations reflect expert opinion from a single, self-selected multidisciplinary session rather than formal consensus, they provide a practical framework for translating national pediatric readiness standards into regional action. Improving pediatric readiness will require collaboration across trauma centers regardless of level or verification status, with shared responsibility for ensuring that every facility caring for injured children can provide appropriate initial stabilization and emergency care.