Abstract
Trauma is the leading cause of morbidity and mortality in children aged over 1 year. Whilst the management of children after trauma follows the same principles as adults, there are unique features of pediatric trauma. The patterns of injuries are different in children of different ages. Children have a large head, making them prone to head injury, but also prone to upper cervical spine injuries rather than the lower cervical spine affected in adults. Head trauma tends to cause diffuse, axonal injury and cerebral edema rather than focal collections. The relatively flexible tissues of children allow great force to be transmitted internally, and there can be significant injury in the chest or abdomen with few external signs. Once injured, a child can compensate for significant blood loss and maintain a relatively normal blood pressure, before sudden decompensation and cardiovascular collapse. Children are also prone to burns—scalds in young child, flame burns in older children. Children with large burns are prone to hypothermia and hyponatremia during fluid resuscitation, and quickly become catabolic after their burn.
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Further Reading
Cullen PM. Pediatric trauma. Cont Educ Anesth Crit Care Pain. 2012;12:157–61.
Goergen S et al. Pediatric cervical spine trauma. In: Education modules for appropriate imaging referrals: Royal Australian and New Zealand College of Radiologists. 2015. https://www.ranzcr.com/our-work/quality-standards/education-modules. Accessed July 2019.
Gopinathan NR, Viswanathan VK, Crawford AH. Cervical spine evaluation in pediatric trauma: a review and an update of current concepts. Indian J Orthop. 2018;52:489–500.
Jamshedi R, Sato TT. Initial assessment and management of thermal burn injuries in children. Pediatr Rev. 2013;34:395.
Kanani AN, Hartshorn S. NICE clinical guideline NG39: major trauma: assessment and initial management. Arch Dis Child Educ Pract Ed. 2017;102(1):20–3.
McDougall RJ. Paediatric emergencies. Anaesthesia. 2013;68(Suppl.1):61–71.
Mitchell RJ, Curtis K, Foster K. A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia. Inj Prev. 2018;24:344–50.
Sheridan RL. Burn care for children. Pediatr Rev. 2018;39:273–83. A very good, contemporary overview.
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Review Questions
Review Questions
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1.
A 20 kg child suffered 20% full thickness burns 6 h ago. What would be the optimum volume of crystalloid fluid resuscitation for the first hour?
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(a)
160 mL
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(b)
260 mL
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(c)
360 mL
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(d)
460 mL
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(e)
660 mL
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(a)
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2.
A 2 year old child has burns to lower body from immersion into a hot bath. Describe your assessment and management of pain in the first 24 h following injury. Describe your assessment of a 5 year old child, who has been rescued from a house fire.
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3.
A 4 year boy was injured in a traffic accident. On arrival at hospital, he has weak pulses and an unrecordable BP. Peripheral IV cannulation was unsuccessful. What are the alternative routes of vascular access and outline the disadvantages and complications of these routes?
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Hegarty, M. (2020). Trauma and Burns. In: Sims, C., Weber, D., Johnson, C. (eds) A Guide to Pediatric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-030-19246-4_25
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DOI: https://doi.org/10.1007/978-3-030-19246-4_25
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