Pediatric trauma patients

Abstract

Optimal pediatric trauma patient care includes adequate initial assessment and early aggressive resuscitation (ideally initiated at the trauma scene by a field physician), transportation of a stabilized patient to a pediatric trauma center, and conservative surgical management as often as possible. Since severe head trauma is preponderant in this population, one of the major goals of initial critical care management is aimed at preventing secondary brain damage, especially hypoxia and hypotension. Fluid resuscitation using hypertonic saline has shown significant benefit in severely head-injured children. Improvement in diagnosis imaging represents a crucial advance in pediatric trauma care, with ultrasonography used as the first line investigation, and computed tomography scan as the gold standard in stabilized and adequately monitored children. Finally, even though the concentration of patients induces improvement in the level of expertise of trauma care providers, it may interfere with the quality of care in high volume centers overloaded by minor trauma.