Pediatric Trauma

Course overview

Objectives Explain the unique needs and challenges associated with pediatric trauma Explain pediatric development and the physiological changes that occur during growth List special management considerations of treating pediatric patients Content Information Covered Pediatric fractures Pathophysiology Review previous knowledge Types of fractures Epiphyseal at bone growth plate Greenstick incomplete fracture from bending bone Torus buckling of cortex of bone Immature growth of bones Growth plates at end of bones and complications of epiphyseal fractures Special assessment findings Review previous knowledge Mechanism of injury assess for abuse Motor sensory pulse assessment distal to injury Child parent interaction Age differences and reaction to trauma Assess for comorbidity Special management considerations Review previous knowledge Airway ventilation oxygenation Transport with family members Consent issues when family not present injury not serious Inform family teachers guardians of transport location Immobilization the same as adults Ice will reduce swelling Pediatric Trauma Unique pediatric aspects of trauma Pathophysiology Head most commonly injured Larger than adults Large occiput flexes head compromising airway Suture flexibility in very young Newborns and infants can become hypotensive with head injuries Spine Spinal cord injury without radiographic abnormality Chest Very compliant injury requires great force Commotio cordis sudden impact of blunt force to the chest resulting in cardiac dysfunction or death Abdomen Larger solid organs Weak abdominal muscles Musculoskeletal Epiphyseal plate Bones heal faster Special considerations in assessment Airway breathing and circulation Circulation Hypotension appears late use other signs of inadequate circulation Inadequate oxygenation causes bradycardia Capillary refill may be helpful Level of consciousness may indicate inadequate circulation Blood pressure estimated as eighty plus two times the age Appropriate blood pressure cuff size Eighty milliliters per kilogram blood loss can cause shock Head Very vascular even scalp laceration can cause shock Falls less than five feet are significant Beware of shaken baby syndrome Glasgow Coma Scale less than eight means increased intracranial pressure Chest Significant internal injury can be present without external signs Tension pneumothorax is difficult to evaluate Abdomen Spleen most commonly injured Cullens sign Kehrs sign Musculoskeletal trauma Special considerations in management Airway breathing and circulation improper management is the most common cause of preventable pediatric death Circulation Head Spinal Adequate size cervical collars are important Padding with immobilization Abdomen Extremity Transportation