Previous research has shown that many children with injuries consistent with the definition of major trauma are brought to the ED by their carers without activation of pre-hospital resources. Such children who ‘self-present’ may not be identified as promptly or receive trauma team activation (TTA) compared with those arriving by ambulance.1 Relatively little is known about this patient group, the injuries that bring them to the ED or the severity of their injuries.

This service evaluation was a case series of paediatric patients with injuries found to be consistent with major trauma self-presenting to an inner-city major trauma centre (MTC) in the UK between 5 August 2020 and 6 May 2022. Consecutive paediatric patients (<16 years of age) who arrived at the ED without activation of EMS with injuries significant enough to be added to the National Trauma Audit and Research Network (TARN) …