New Technologies in Pediatric Trauma

Abstract

Trauma remains the leading cause of death for children and adolescents, most often due to blunt trauma from falls or motor vehicle collisions (Stewart et al., National trauma data bank pediatric annual report, p. 32, 2016). Traumatic brain injury is the most common cause of death overall. Of potentially preventable deaths, hemorrhage accounts for almost half (Drake et al., Pediatr Surg Int 36(2):179–189, 2020). Interestingly, pediatric trauma patients are less likely to undergo invasive procedures. Two level-1 trauma centers in Denver, Colorado, had an overall rate of emergent intervention of 0.6% over almost two decades (Boatright et al., J Am Coll Surg 216(6):1094–102, 2013). Efforts are underway to tailor advances made in adult trauma to pediatric trauma management. The purpose of this chapter is to outline several new technological advances aimed at providing less invasive care for pediatric trauma patients; retrograde endovascular balloon occlusion of the aorta (REBOA) for systemic hemorrhage control, direct site endovascular hemorrhage control and repair, point-of-care ultrasound (POCUS) of optic nerve sheath diameter (ONSD) for intracranial pressure (ICP) monitoring, POCUS of lungs for pediatric acute respiratory distress syndrome (PARDS) management, and pulse co-oximetry monitoring for solid organ injury management.