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  • Print publication year: 2008
  • Online publication date: January 2010

24 - Pediatric Trauma and Anesthesia

Summary

Objectives

Describe the differences between pediatric and adult trauma.

Explain the initial evaluation and management priorities in an injured pediatric patient.

Describe the developing physiologic and anatomical characteristics of infants and children.

Identify anatomical characteristics of the pediatric airway and describe the associated implications for airway management after trauma with potential cervical spine injury.

Describe fluid options and blood product resuscitation for a bleeding pediatric patient.

Explain the anesthetic considerations applicable to the care of an injured child, and how trauma influences the choice of medications and other elements of the anesthetic plan.

Describe the physiology and pharmacology of drugs used in the management of injured infants and children.

List alternatives available for the management of pediatric acute postoperative pain, and explain the advantages and disadvantages of each.

Trauma remains the leading cause of mortality and serious long-term morbidity in the pediatric population. A significant majority of pediatric trauma occurs in motor vehicle accidents. Injuries related to falls and sports comprise the second largest group. Other causes include drowning, child abuse, and burns. Falls from heights are most common in toddlers, while older children sustain more traumatic injuries from motor vehicle and bicycle accidents [1]. Homicide is the leading cause of traumatic death in infants, 50 percent occurring in the first four months after birth [2]. Pediatric injuries vary from minor and isolated, to severe, multiple, and potentially fatal, involving several organ systems.

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