Abstract
Management of trauma is generally divided into major trauma, which involves urgent procedures such as establishing a clear airway and adequate venous access to initiate volume resuscitation and minor trauma. Patients with head injury require special management to stabilize the cervical spine (children may have high cervical spine injury without radiographic evidence) and appropriate in-line stabilization during laryngoscopy and intubation, as well as ongoing assessments to classify severity of injury with the Glasgow coma scale and its pediatric modification. Head injury requires specific measures to reduce intracranial pressure. Patients with major blood loss need volume resuscitation with a balanced salt solution initially to restore perfusion; upper extremity IVs are preferred if there is potential for major organ injury or caval disruption. The child demonstrating pallor, sweating, and hypotension must be assumed to have lost >25 % of the blood volume. Be prepared for massive transfusion and possible dilutional coagulopathy.
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Lerman, J., Coté, C.J., Steward, D.J. (2016). Trauma, Including Acute Burns and Scalds. In: Manual of Pediatric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-319-30684-1_17
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DOI: https://doi.org/10.1007/978-3-319-30684-1_17
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