Injuries In Children By Dr. Vivek Rege. Injuries can occur in children right from newborn onward. There are various mechanisms of injuries and type of injuries. Some of which can be life threatening if not corrected in time. Injuries are more common in boys.Injuries to Chest & Abdomen need to be carefully evaluated. For info log on to www.healthlibrary.com

1. Injuries in ChildrenInjuries in Children
Dr. Vivek M. RegeDr. Vivek M. Rege
Pediatric & Neonatal Surgeon
Saifee HospitalSaifee Hospital
Bhatia HospitalBhatia Hospital
Wadia Hospital for ChildrenWadia Hospital for Children
Fortis HospitalFortis Hospital
Dr Vivek Rege Pediatric Surgeon

2. Types of InjuriesTypes of Injuries
• External blunt injuriesExternal blunt injuries
• External/Visible cut injuriesExternal/Visible cut injuries
• Internal blunt injuriesInternal blunt injuries
• Penetrating injuriesPenetrating injuries
Dr Vivek Rege Pediatric Surgeon

3. Mechanism of injuryMechanism of injury
• Massage in newbornsMassage in newborns
• Fall while walking/running/sports/heightFall while walking/running/sports/height
• Vehicular accident: pedestrian/ in vehicleVehicular accident: pedestrian/ in vehicle
• Crush injury: door, heavy objectCrush injury: door, heavy object
• Sharp object : impalement/ bitesSharp object : impalement/ bites
• Large object falling on child: chest /Large object falling on child: chest /
abdomenabdomen
Dr Vivek Rege Pediatric Surgeon

4. Site of InjurySite of Injury
• Head injuryHead injury
• Face , neck, mouth injuryFace , neck, mouth injury
• Chest injuryChest injury
• Abdominal injuryAbdominal injury
• Limb injuryLimb injury
Dr Vivek Rege Pediatric Surgeon

5. Breast abscess following massageBreast abscess following massage

6. Breast abscess following massageBreast abscess following massage

12. Abrasions due to dragging along ground by 3Abrasions due to dragging along ground by 3
dogs who attacked this boydogs who attacked this boy
Dr Vivek Rege Pediatric Surgeon

13. Following a dog bite - abrasions & woundFollowing a dog bite - abrasions & wound
Major cutMajor cut
AbrasionsAbrasions
Dr Vivek Rege Pediatric Surgeon

14. Deep wound - includes skin & musclesDeep wound - includes skin & muscles
Dr Vivek Rege Pediatric Surgeon

15. Dr. Vivek M. Rege
CLWCLW
• Scratched by a PumaScratched by a Puma
• Injury on the noseInjury on the nose
• Active bleedActive bleed
• Deep cutDeep cut
• Requires suturingRequires suturing

16. Dr. Vivek M. Rege
After suturingAfter suturing
Excellent healingExcellent healing
Good scarGood scar

17. Large cut across tongueLarge cut across tongue
Always to be done under anesthesiaAlways to be done under anesthesiaDr Vivek Rege Pediatric Surgeon

18. CLW tongue
Dr Vivek Rege Pediatric Surgeon

19. After suturing with self absorbable suturesAfter suturing with self absorbable sutures
CutCutDr Vivek Rege Pediatric Surgeon

20. After suturing the under surface of the tongue wound
Dr Vivek Rege Pediatric Surgeon

21. Dr. Vivek M. Rege
Crush injury to the fingerCrush injury to the finger

22. Dr. Vivek M. Rege
Crush injury all around fingerCrush injury all around finger

23. Finger crushed in doorFinger crushed in door

24. Finger crushed in doorFinger crushed in door

25. After cleaning & suturing

27. Final result 10 days

28. FingerFinger
waswas
caughtcaught
in thein the
door anddoor and
the skinthe skin
waswas
avulsedavulsed
Dr Vivek Rege Pediatric Surgeon

29. Avulsed skin brought along in plasticAvulsed skin brought along in plastic
bagbag
Dr Vivek Rege Pediatric Surgeon

30. After total healing - excellent resultAfter total healing - excellent result
Dr Vivek Rege Pediatric Surgeon

31. Child fell on the handle of cupboard

39. Injuries requiring suturesInjuries requiring sutures
• Must be recognised earlyMust be recognised early
• Referred to a surgeon earlyReferred to a surgeon early
• Stop all oral intake immediatelyStop all oral intake immediately
• Send to a hospital directlySend to a hospital directly
• Suturing must be within first 6 hoursSuturing must be within first 6 hours
ideallyideally
Dr Vivek Rege Pediatric Surgeon

40. Head InjuriesHead Injuries
• Ask if child had unconsiousnessAsk if child had unconsiousness
• Ask if child had bleeding ear/nose/ mouthAsk if child had bleeding ear/nose/ mouth
• Ask if child had convulsionAsk if child had convulsion
• Ask if child has vomitedAsk if child has vomited
• Check if child is orientedCheck if child is oriented
• No oral feeds till seen by doctorNo oral feeds till seen by doctor
Dr Vivek Rege Pediatric Surgeon

41. Blunt injury – Chest & AbdomenBlunt injury – Chest & Abdomen
• Blunt injury caused by fall, sports, an object falling onBlunt injury caused by fall, sports, an object falling on
the bodythe body
• External injury may look small – bruise, scrape orExternal injury may look small – bruise, scrape or
hematomahematoma
• Internal injury may be very major – tear of an organ orInternal injury may be very major – tear of an organ or
vesselvessel
• NEVER take chest / abdomen injury casually – go to theNEVER take chest / abdomen injury casually – go to the
nearest hospital and shownearest hospital and show
Dr Vivek Rege Pediatric Surgeon

42. Blunt Injury ChestBlunt Injury Chest
• Child was playing around a scooterChild was playing around a scooter
• Scooter accidentally fell on her chestScooter accidentally fell on her chest
• She developed swelling from chestShe developed swelling from chest
upwards to face and down to abdomenupwards to face and down to abdomen
• Difficulty in breathing progressiveDifficulty in breathing progressive
• Time lag: 2 hours after injuryTime lag: 2 hours after injury
Dr Vivek Rege Pediatric Surgeon

43. Dr Vivek Rege Pediatric Surgeon

44. Dr Vivek Rege Pediatric Surgeon
Swelling up toSwelling up to
face , crepitationsface , crepitations
all over upperall over upper
body due tobody due to
leakage of airleakage of air
from the lungsfrom the lungs
outsideoutside
Sternal fractureSternal fracture

45. Dr Vivek Rege Pediatric Surgeon
LungLung
collapsed,collapsed,
airair
outsideoutside
the lungthe lung

46. Tear inTear in
the rightthe right
mainmain
bronchusbronchus
LungLung LungLung
Dr Vivek Rege Pediatric Surgeon

47. FullFull
recoveryrecovery
before goingbefore going
home fromhome from
the Hospitalthe Hospital
Dr Vivek Rege Pediatric Surgeon

48. Fall from the loft on an open stoveFall from the loft on an open stove
Chest Injury(Penetrating)
Dr Vivek Rege Pediatric Surgeon

49. Penetrating injuryPenetrating injury
• Third rod of stove inside the childs’ chestThird rod of stove inside the childs’ chest
• No difficulty in breathingNo difficulty in breathing
• No gross bleedingNo gross bleeding
• No major organ/vessel damageNo major organ/vessel damage
• Child was very luckyChild was very lucky
Dr Vivek Rege Pediatric Surgeon

50. Fall from the loft on an open stoveFall from the loft on an open stove
Chest Injury(Penetrating)
Dr Vivek Rege Pediatric Surgeon

51. Trachea & Esophagus normal no
subcut. emphysema
Penetrating Injury neck midline
fall on an Iron rod
Dr Vivek Rege Pediatric Surgeon

52. Fall on a sharp compound fenceFall on a sharp compound fence
Entry wound shows muscles cutEntry wound shows muscles cut
Dr Vivek Rege Pediatric Surgeon

53. Exit wound in floor of mouth
Tongue
Dr Vivek Rege Pediatric Surgeon

54. Glove finger seen inserted
from entry wound
Dr Vivek Rege Pediatric Surgeon

55. Tract of the iron rod seen
Dr Vivek Rege Pediatric Surgeon

56. Muscles sutured in midline
Dr Vivek Rege Pediatric Surgeon

57. Dr Vivek Rege Pediatric Surgeon

58. Exit wound also closed
Dr Vivek Rege Pediatric Surgeon

59. Post operative healing excellentDr Vivek Rege Pediatric Surgeon

60. Burns due to Kerosene can falling on the boys headBurns due to Kerosene can falling on the boys head
& face due to rats on the loft. Boy was sitting in& face due to rats on the loft. Boy was sitting in
front of a stovefront of a stove
Dr Vivek Rege Pediatric Surgeon

61. After local application of Amniotic membraneAfter local application of Amniotic membrane
Dr Vivek Rege Pediatric Surgeon

62. Healing of burns onHealing of burns on
the face and neck &the face and neck &
trunk on the backtrunk on the back
Dr Vivek Rege Pediatric Surgeon

63. Dr Vivek Rege Pediatric Surgeon