Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
9.9 - Trauma
from Section 9 - Paediatric Care
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Introduction
- Differences
- Clinical Assessment
- Introduction
- Scoring Systems and Quality Metrics in PICU
- Paediatric Intensive Care Transport Services
- Changing Patterns of PICU
- Relevance to the Intensivist
- How Widespread Is Child Abuse?
- Types of Abuse
- The Safeguarding Process – Roles, Responsibilities and Processes
- Respiratory Anatomy and Physiology in Children
- Upper Airway Obstruction
- Intubating the Child with Upper Airway Obstruction
- Paediatric Acute Respiratory Distress Syndrome
- Diseases of the Lower Airway
- High-Flow Nasal Cannulae
- Continuous Positive Airway Pressure
- Mechanical Ventilation
- High-Frequency Oscillatory Ventilation
- Extracorporeal Membrane Oxygenation
- Definition and Recognition of Sepsis
- Patterns of Sepsis Presentation
- Haemodynamics of Paediatric Septic Shock
- Protocolised Management of Sepsis
- Current Controversies
- Outcomes in Sepsis and Septic Shock
- Introduction
- Status Epilepticus
- Coma
- Neurosurgical Emergencies
- Introduction
- Initial Management
- Sudden Unexpected Death in Infancy and Sudden Infant Death Syndrome
- Introduction
- Presentation in Infancy
- Diagnosis and Management of Infants with Suspected Congenital Heart Disease
- Norwood Stage 1, Glenn or Fontan
- Acute Presentations
- Introduction
- The Primary Survey
- Head Injury
- Cervical Spine Injury
- Introduction
- Acute Liver Failure
- Inborn Errors of Metabolism
- Diabetic Ketoacidosis
- Introduction
- Analgesic Agents
- Sedative Agents
- 9.1 Assessment and Management of the Sick Child
- 9.2 Organisation of Paediatric Intensive Care and Paediatric Intensive Care Transport Services in the UK
- 9.3 Safeguarding and Non-accidental Injury
- 9.4 Respiratory Failure
- 9.5 Paediatric Sepsis
- 9.6 Acute Neurological Disorders
- 9.7 The Collapsed Infant
- 9.8 Congenital Heart Disease
- 9.9 Trauma
- 9.10 Acute Liver Failure, Inborn Errors of Metabolism and Diabetic Ketoacidosis
- 9.11 Analgesia and Sedation in the Paediatric Intensive Care Unit
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Trauma is the leading cause of death in children older than 1 year.
2. An isolated head injury is the most common presentation of major trauma.
3. Consider non-accidental injury in all children, particularly in those <2 years.
4. Have a high index of suspicion for cervical spine injury, and consider spinal cord injury without radiographic abnormality (SCIWORA) in younger children.
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.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 719 - 721Publisher: Cambridge University PressPrint publication year: 2021
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