J Korean Med Assoc.  2008 Mar;51(3):219-229.

Initial Stabilization in Severely Injured Child

• Lee KJ

Abstract

The often quoted statement that children are not simply small adults remains the central premise of pediatric trauma care. Although multiple traumas remain the leading cause of death among children, fewer resources and less attention have been directed to the treatment of an injured child than to that of an injured adult. Insufficient training of medical personnel and lack of expertise in the management of injured children might be the key factors contributing to the disability and deaths in such children. Although the principles of resuscitation of injured children are similar to those for adults, the basic concepts of advanced life support that have been used for adults remain applicable and critical for injured children. However, we need to know the differences in cardiorespiratory variables, airway anatomy, response to blood loss, and thermoregulation, and special equipments are essential for successful initial resuscitation. Cerebral, abdominal, and thoracic injuries are still the major causes of mortality, morbidity, and disability among traumatized children. Brain parenchymal damage is caused by secondary injuries, such as hypovolemia and hypooxygenemia, are sometimes preventable and intracranial pressure should be maintained within the normal range. The efforts to keep the spleen in children with trauma may make the management of abdominal trauma complicated. Although children seem to be small and weak, our efforts and skill for pediatric life support will make a good result.

Keyword

Pediatric trauma; Injury; Resuscitation

MeSH Terms

Adult
Body Temperature Regulation
Brain
Cause of Death
Child
Humans
Hypovolemia
Intracranial Pressure
Multiple Trauma
Reference Values
Resuscitation
Spleen
Thoracic Injuries

Figure

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  Figure 1 Sellick Maneuver.

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  Figure 2 Nasotracheal intubation in adult patients. Generally, it's not allowed to do in child patient.

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  Figure 3 Cricothyroidotomy.

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  Figure 4 Femoral vein catheterization.

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  Figure 5 A) Intraosseous infusion for 5-year-old boy. B) Insertion of intraosseous needle in the right tibia.

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  Figure 6 Intracranial pressure monitoring.

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