Pediatric Trauma

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Pediatric Trauma

• Tintinalli Chapter 252

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Epidemiology

• Leading cause death / disability lt 1 yr.
• 1MVA

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Trauma Resuscitation Priorities

• Same as adults
• AcBCDE

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Prehospital Considerations

• Minimize scene time
• IV rates gt93
• ET rates 57 79

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Postresuscitation Priorities

• Secondary survey
• Head to toe
• X-rays
• Keep family with child if possible
• Stabilize
• Refer to specialty center

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Specific Pediatric Injuries

• Head trauma
• Head big in small children
• Similar symptoms to children
• Increased ICP
• Manitol
• Post traumatic seizures
• Uncommon 5
• Radiology
• CT or MRI

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Spinal Trauma

• Uncommon in young children
• Increased flexibility in young
• SCIWORA possible
• Clinical
• Radiography
• NEXUS
• Management

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Chest Trauma

• Compliant chest walls
• Standard AP CXR
• Rib fracture most sensitive indicator

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Abdominal Trauma

• Physical examination may be misleading
• DPL replaced by CT

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Splenic Trauma

• Most commonly injured organ in children

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Hepatic Trauma

• Second most commonly injured in chidren

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Pancreatic Trauma

• Uncommon

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Bowel Trauma

• lt5 of children with blunt injuries
• 1 Jejunum
• 2 Ileum
• 3 Cecum
• Duodenum prone to hematoma
• Seatbelt cause lt5 of admitted trauma
• Higher when belt incorrectly applied

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Pelvic and GU Trauma

• Uncommon in children
• Consider with
• Pelvic fracture
• Flank injury
• Back or groin injury
• Straddle injuries
• Urethral injury
• Pubic fracture
• Testicular injuries
• Labial or scrotal injuries

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Journal Article
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Questions?