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9.9 - Trauma

from Section 9 - Paediatric Care

Published online by Cambridge University Press:  27 July 2023

By
Andrew J. Jones  and
Thomas Brick
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Trauma is the leading cause of death in children older than 1 year.

  2. 2. An isolated head injury is the most common presentation of major trauma.

  3. 3. Consider non-accidental injury in all children, particularly in those <2 years.

  4. 4. Have a high index of suspicion for cervical spine injury, and consider spinal cord injury without radiographic abnormality (SCIWORA) in younger children.

  5. 5. If cervical spine injury is suspected in the comatose child, immobilisation should be continued until adequate imaging and/or clinical assessment can be performed.

Keywords

traumaprimary surveyhead injurycervical spine
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 719 - 721
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

CRASH-2 Trial Collaborators; Shakur, H, Roberts, I, Bautista, R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet 2020;276:23–32.Google Scholar
Hoffman, JR, Mower, WR, Wolfson, AB. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med 2000;343:94–9.CrossRefGoogle Scholar
Holcomb, JB, Tilley, BC, Baraniuk, S, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA 2015;313:471–82.CrossRefGoogle Scholar
Kochanek, PM, Carney, N, Adelson, PD. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents – second edition. Pediatr Crit Care Med 2012;13(Suppl 1):S1–82.CrossRefGoogle ScholarPubMed
London Ambulance Service. Annual report 2016/17. www.londonambulance.nhs.uk/wp-content/uploads/2020/01/London-Ambulance-Service-Annual-Report-2016-2017_.pdfGoogle Scholar
National Institute for Health and Care Excellence. 2014. Head injury: assessment and early management. www.nice.org.uk/guidance/cg176Google Scholar
Polke, E, Lutman, D; Children’s Acute Transport Service. 2020. Transport considerations when transfer undertaken by local DGH team. cats.nhs.uk/wp-content/uploads/guideline-localteamtransfer.pdfGoogle Scholar

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