The Injured Child

Question 1

What are the common injuries in children?

Answer 1

Fractures
Wounds
Burns + scalds
Head injuries
Drowning

Question 2

For what reasons do children injure differently than adults?

Answer 2

Size- smaller target, large surface area:volume ratio, relatively large head
Skeleton- incompletely calcified, provides less protection for vital organs
Inside- less elastic connective tissue, crowding of poorly protected vital organs
Metabolism- thermoregulatory and hypoglycaemic differences

Question 3

What are the common manifestations of life threatening trauma?

Answer 3

Respiratory obstruction:
-Foreign body inhalation
-Pneumothorax
Respiratory depression:
-Raised ICP
-Head injury
-Poisoning
Fluid loss:
-Burns
-Trauma 
Fluid maldistribution:
-Sepsis

Question 4

When do the three peaks of death in trauma occur?

Answer 4

The first peak of deaths in trauma occurs in those that die instantaneously or at the scene. These deaths are usually due to un-survivable major vessel and brain injury.
The second peak of deaths occur in those who die from significant ABCD problems unless resuscitated. Outcomes in this group can be improved, particularly within the “golden hour” period.
The third peak of deaths involve delayed deaths despite resuscitation, surgery and intensive care. They usually involve multi-organ failure or sepsis.

Question 5

What is involved in the primary assessment of paediatric trauma?

Answer 5

• catastrophic haemorrhage control
• Airway with C-spine – remember O2!
• Breathing with Ventilation
• Circulation with Haemorrhage Control
• Disability
• Exposure/Environment
• Don’t Ever Forget Glucose!