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Some states -- Hawaii, Maine, Montana, New Mexico, North Dakota and Wyoming -- offer almost no access to a verified pediatric trauma center in less than an hour.

However, virtually all children living in other areas -- such as the District of Columbia, New Jersey, Connecticut, Maryland, Massachusetts and Rhode Island -- are within 60 minutes of specialized trauma care.

"This study shows that access to pediatric trauma centers is variable and inadequate in many areas of the United States", study lead author Dr. Michael Nance of the Children's Hospital of Philadelphia said in a statement. "We need to set up guidelines to help hospitals understand what is required to establish a pediatric trauma center where those centers should be."

For this study, the records of the American College of Surgeons Committee on Trauma were combined with "pediatric capable" centers on the American Trauma Society's list and self-classified trauma center members of the National Association of Children's Hospitals and Related Institutions.

"The lack of a single national accrediting body or uniform standards for pediatric trauma centers has been an obstacle to understanding the resources that exist for the care of our most severely injured children", said Nance.

The findings are published in the Archives of Pediatrics and Adolescent Medicine.

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