Pediatric Trauma and Critical Illness Branch (PTCIB)

We are interested in applications that align with the following research priorities. For more information about NICHD’s research themes, cross-cutting topics, and aspirational goals, visit the plan’s Scientific Research Themes and Objectives.

Optimal Time Periods for the Prevention and Treatment of Traumatic Injuries

Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Cross-Cutting Topic: Disease Prevention

Gap: Injury is the leading cause of morbidity and mortality in children and adolescents, yet it is an understudied public health problem in the United States and around the world with serious effects on health, well-being, and developmental transitions. Research is needed to prevent adverse health outcomes and developmental sequelae by improving early detection and treatment and by identifying optimal time periods for prevention and intervention efforts. 

Priority: Research to develop the most effective prevention, diagnostic, and treatment strategies for the leading causes of traumatic injury in children and adolescents, including all forms of violence against children; unintentional injury, including motor vehicle crashes; critical illness and life-threatening injury; and self-injurious behavior.

Gap: Little is known about multiple forms of trauma in children or about the independent and combined effects of multiple forms of physical and psychological trauma or traumatic stress in children. More research is needed to understand how these forms of trauma affect children’s short- and long-term recovery, as well as overall health and well-being, through key developmental transition points.

Priority: Multidisciplinary research that examines the distinctive aspects of psychological and physical trauma, the complex interplay of those traumas, and the implications for trauma-informed systems of care and treatment of diverse pediatric populations in primary care, community, humanitarian, emergency medical, or critical care contexts.

Collaborative Multidisciplinary Research Across the Continuum of Care

Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Aspirational Goal: Facilitate application of precision medicine approaches in children

Gap: The current approach to studying pediatric trauma, injury prevention, and critical illness is often compartmentalized, with each discipline operating independently. This approach is insufficient to advance the science, accelerate discovery, inform clinical practice, and establish the scientific evidence needed for effective treatment of critically ill, injured, or traumatized children. 

Priority: Research involving multidisciplinary and interdisciplinary teams to develop, test, and evaluate effective therapeutic agents and modalities, medical devices, precision medicine interventions, behavioral interventions, and large-scale datasets to optimize outcomes for traumatized, injured, and critically ill children.

Care and Treatment of Critical Illness in Pediatric Populations

Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Cross-Cutting Topic: Infectious Disease

Gap: Critical illness in children is an under-recognized major public health problem that accounts for more quality of life years lost than any other medical condition. Critical illness may occur with a wide variety of medical conditions, rare diseases, and life-threatening injuries, making the completion of generalizable studies quite difficult. The impact of these illnesses on the developmental trajectory is poorly understood. Additionally, therapies for these illnesses and rare conditions are most often based on extrapolated adult data. Given that a child’s physiological responses to critical illness differ substantially from those of an adult, there exists a large gap in knowledge regarding optimal therapy for these conditions among children.

Priority: Research that optimizes recovery for children who experience critical illness and/or traumatic injury. This includes research that examines the epidemiology, pathophysiology, diagnosis, prevention, and treatment of all forms of critical illness and life-threatening injury among non-neonatal pediatric populations, as well as identifying sensitive time periods when prevention and treatment strategies are most optimal for children.

Gap: Children with complex medical conditions or rare diseases are frequently dependent upon technology and highly specialized care to survive and thrive, especially during periods of life-threatening illness, such as infections or respiratory distress or failure. Balancing the unique needs of these patients due to their underlying condition or disease with the life-saving measures and technology required can be challenging, at best, yet little research exists to substantiate and direct care. Empirical efforts are needed to develop, test, and evaluate safe and effective solutions that meet the unique needs of critically ill children with complex medical conditions.

Priority: Research designed to determine the optimal use of—and identify patient populations most likely to benefit from—innovative critical care interventions (e.g., extracorporeal membrane oxygenation [ECMO], renal replacement therapy [RRT], etc.), including research that assesses morbidities and functional outcomes related to those treatment modalities.

Psychosocial Issues Related to the Care of Critically Ill and Injured Children and Their Families

Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood

Gap: Stress related to critical care illness and injury, as well as the inherent ethical concerns and conflicts that contribute to that stress, create a myriad of psychosocial concerns for the child, family, and healthcare providers, yet these concerns and how they might affect clinical outcomes remain grossly understudied. Similarly, both the short-term and long-term psychological consequences of critical illness and injury on these populations are largely unknown. 

Priority: Research aimed at understanding psychosocial issues in critically ill children and their families, as well as ethical and communication issues that arise in the Pediatric Intensive Care Unit, and approaches to reducing the negative sequelae of these issues. Also prioritized is research aimed at understanding the effect of environmental and palliative care interventions in critically ill or injured children on functional outcomes and the psychological consequences of critical stress.

• Pediatric Critical Care Research: Informs the practice of healthcare providers who stabilize, diagnose, and manage the care of critically ill and severely injured children of all ages
• Pediatric Trauma Research: Advances the science of trauma and injury prevention, treatment, and short-term recovery for pediatric populations, with the goal of reducing morbidity and mortality in children
• Collaborative Pediatric Critical Care Research Network: Supports efforts to reduce morbidity and mortality in pediatric critical illness and injury, and to provide a framework for the development of the scientific basis of pediatric critical care practice
• CAPSTONE Centers for Multidisciplinary Research in Child Abuse and Neglect: Specialized research centers that serve as a national resource for research on child abuse and neglect
• Community Level Interventions for Firearm and Related Violence, Injury, and Mortality Prevention Network: Supports research projects to develop, implement, and evaluate innovative interventions that modify characteristics of organizations, environments, and/or settings to address higher order, “root” causes of firearm mortality and injury 
• Pediatric Critical Care and Trauma Scientist Development Program: Trains scholars and junior-level faculty candidates to be pediatric critical care and pediatric trauma physician-scientists

• President's Task Force for Environmental Health Risks and Safety Risks to Children: Coordinates federal government efforts to explore, understand, and act together to improve children’s safety and environmental health. PTCIB participates in the subcommittee on climate, emergencies, and disasters.
• Action Collaborative on Disaster Research: Co-chaired by PTCIB staff, provides subject matter experts with a space for discussing strategies to improve the quality of disaster research used to inform the U.S. response to health threats affecting children and other populations. In 2022, the collaborative convened a symposium on pediatric disaster science that focused on scientific needs related to disasters affecting children.
• Pediatric Intensive Care Core Outcomes Set: A guide to ensure that outcomes most important to all stakeholders are considered in pediatric intensive care unit (PICU) clinical research programs
• The Functional Status Scale for Pediatric Hospitalization Outcomes: A Tool for Researchers: Helps measure functional status of children during hospital admissions
• Long-Term Ventilation Information and Decision-Making Support: Outlines the risks, benefits, and impact of long-term ventilation for families with a child who has or is at risk for chronic respiratory failure. Available in English and Spanish. Created as part of a PTCIB grant, the booklet addresses both invasive ventilation, such as a tracheostomy, and noninvasive ventilation, such as a continuous positive airway pressure machine.
• American Academy of Pediatrics Reports and Resources: Selected reports that provide information regarding the state of the science and best practices in the following areas related to PTCIB priorities:
  • Access to Optimal Emergency Care for Children
  • Child Passenger Safety
  • Ensuring the Health of Children in Disasters
  • Firearm-Related Injuries Affecting the Pediatric Population
  • Inflicted Childhood Neurotrauma
  • Management of Pediatric Trauma
  • Prevention of Drowning
  • The Lifelong Effects of Early Childhood Adversity and Toxic Stress
• Institute of Medicine/National Academies of Medicine Reports: Selected publications and meeting proceedings that provide information regarding the state of the science and best practice in the following areas related to PTCIB priorities:
  • Emergency Care for Children: Growing Pains
  • New Directions in Child Abuse and Neglect Research
  • Sports-Related Concussions in Youth: Improving the Science, Changing the Culture
• Agency for Strategic Preparedness and Response Resources
  • National Advisory Committee on Children and Disasters
  • HHS Child and Adolescent Health Emergency Planning Toolkit (PDF 3.89 MB)
• Centers for Disease Control and Prevention Fact Sheets and Resources: Selected data sources that provide data tables and information in the following areas related to PTCIB priorities:
  • CDC Technical Packages for Violence Prevention
  • Centers for Disease Control and Prevention (CDC) Quick Facts & Stats about Child Abude and Neglect
  • Child Passenger Safety
  • National Center for Injury Prevention and Control Web-Based Injury Statistics Query and Reporting System (WISQARSTM)
  • Violence Against Children Surveys
  • Youth Violence Quick Facts and Figures
  • School Preparedness
• Pediatric Critical Care Medicine: Provides news on courses and conferences, clinical research, and clinical resources for all members of the health care team
• National Institute of Neurological Disorders and Stroke Common Data Elements (CDEs): Provides several libraries of CDEs, data standards, and accompanying tools to help investigators collect and record standardized clinical data for neurological disorders, including subdomains for pediatric populations:
  • Sport-Related Concussion
  • Traumatic Brain Injury (TBI) 
• Federal Interagency TBI Research: Informatics system developed to share data across the entire TBI research field and to facilitate collaboration between laboratories as well as interconnectivity with other informatics platforms
• Substance Abuse and Mental Health Services Administration (SAMHSA)
  • National Child Traumatic Stress Initiative (NCTSI): Transforms mental health care for children and adolescents affected by trauma by improving the quality of community-based trauma treatment and services and increasing access to effective trauma-focused interventions
  • National Child Traumatic Stress Network: Funded through SAMHSA/NCTSI to raise the standard of care and improve access to services for traumatized children, their families, and communities
  • Disaster Preparedness, Response, and Recovery
• Child Welfare Information Gateway: A service of the Children’s Bureau, Administration for Children and Families that promotes the safety, permanency, and well-being of children, youth, and families by connecting child welfare, adoption, and related professionals as well as the public to information, resources, and tools covering topics on child welfare, child abuse and neglect, out-of-home care, adoption, and more
• Health Research Services Administration: Selected resources that provide information in the following areas related to PTCIB priorities:
  • Emergency Medical Services for Children Innovation and Improvement Center
  • National Emergency Medical Services for Children Data Analysis Resource Center
  • Pediatric Emergency Care Applied Research Network
  • Pediatric Pandemic Network
• Nationwide Emergency Department Sample: The largest all-payer emergency department database, created by Agency for Healthcare Research and Quality
• Healthy People 2030 Objectives: Data-driven national objectives to improve health and well-being throughout the next decade that include topics on health behaviors such as injury and violence prevention and emergency preparedness, and settings and systems such as hospital and emergency services
• National Highway Traffic Safety Administration (NHTSA) Databases: Research and data from NHTSA’s Office of Vehicle Safety Research and Office of Behavioral Safety Research
• National Center for Fatality Review and Prevention: Provides technical support and data for the Child Death Review and Fetal and Infant Mortality Review
• U.S. Fire Administration: Provides data, prevention, and training resources for fire prevention, mitigation, and response
• U.S. Consumer Product Safety Commission: Includes resources, statistics, and regulations about consumer products, including safety education and prevention resources for homes, indoor/outdoor activities, and recreation
• Ready.gov: Provides disaster and emergency resources for individuals, families, and businesses, including household preparedness research data
• World Health Organization: Selected data sources and reports that provide data and information in the following areas related to PTCIB priorities:
  • Global Emergency and Trauma Care Initiative
  • Drowning Fact Sheet
  • Violence Against Children
  • World Report on Child Injury Prevention (PDF 3.4 MB)

• Valerie Maholmes, Branch Chief
  Main Research Areas: Childhood adversity, child traumatic stress, violence and violence-related injury, abuse, neglect, and maltreatment; training (child maltreatment, violence); psychological response/services to children experiencing/affected by trauma; trauma-informed care and systems; child protection; child welfare
• Jessie Bridgewater, Ph.D., American Association for the Advancement of Science/Society for Research in Child Development Executive Branch Policy Fellow
• Leah Gilbert, Medical Officer
  Main Research Areas: Pediatric trauma (diagnosis, treatment, prevention); childhood adversity, child traumatic stress, violence and violence-related injury, abuse, neglect, and maltreatment; training (child maltreatment, violence); emergency medical and psychological response/services to children
• Cinnamon Dixon, Medical Officer
  Main Research Areas: Emergency medical services for children (EMSC) (prevention, diagnostics, interventions, treatment, utilization, quality); pediatric disaster science  (preparedness, mitigation, response, acute recovery); pediatric unintentional injury prevention and trauma care; global health advancements in EMSC and pediatric disasters; education and training (unintentional injury prevention, EMSC and trauma care, disaster science)
• Tammara Jenkins, Program Official/Nurse Consultant
  Main Research Areas: Pediatric critical care and injury (general, diagnosis, treatment, prevention, ethics, end-of-life issues, environment of care, and psychosocial aspects of critical care); palliative care in the hospitalized child; acute care in the hospitalized child; training and career development (pediatric critical care, and acute care)
• Lauren Jones, Extramural Support Assistant
• Zsuzsanna Kocsis, Program Analyst
• Laureen Lee, Staff Assistant
• Tessie October, Medical Officer
  Main Research Areas: Pediatric critical care and injury (general, diagnosis, treatment, prevention, health care communication, decision-making, small business innovation); training (pediatric critical care, trauma, palliative care)