This paper describes the author’s experience of the paediatric patient load on the UK medical services in Afghanistan. Over a 3 month period there was a mean of 2.9 paediatric trauma admissions per week, mean age was 6.8 years with gunshot wound or explosive injury being the mechanisms of injury in 77% of the trauma admissions. Overall these children represented 10.8% of the surgical workload. Some of the issues of paediatric anaesthesia in this environment are discussed including paediatric equipment, resuscitation for paediatric massive haemorrhage and regional anaesthesia. The need to formally recognise the problem in training and equipping deployed medical personnel to deal with this challenge is examined.
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