1) Pediatric head trauma is a leading cause of death and disability in children, with over 650,000 evaluated per year. The causes vary by age, from abuse and falls in infants/toddlers to motor vehicle crashes and assaults in adolescents.
2) Management involves stabilizing the ABCs, preventing secondary brain injury, and obtaining a CT scan if indicated based on decision rules. For severe injuries, intensive care is needed for ICP monitoring, seizure prophylaxis, and treating complications like hypo/hyperglycemia.
3) While outcomes have improved with specialized pediatric trauma care, severe traumatic brain injury continues to carry high mortality rates around 40% and most survivors have long-term impairments.
This document presents a case of pediatric head injury. It discusses a case of an 11-year-old boy who was unrestrained in a motor vehicle collision and was ejected. He presented with a Glasgow Coma Scale of 4 and required intubation. Imaging showed open skull fractures, brain swelling, and hemorrhages. The document then reviews the epidemiology, pathophysiology, clinical features, decision rules, and management of minor, moderate and severe pediatric head injuries. Special considerations for pediatric head injuries include the increased risk of abuse in young children and anatomical differences that make the skull more vulnerable to injury compared to adults.
Dr Chong Shu Ling - Paediatric head injuryRahul Goswami
The document discusses the management of a 7-year-old girl who presented to the emergency department after being hit by a taxi while crossing the road. On examination, she was crying and oriented but became agitated and drowsy. Her GCS score was assessed and she displayed abnormal flexion in response to pain. The document discusses various clinical decision rules for determining which pediatric patients with head injuries require CT imaging, including the CHALICE, PECARN, and CATCH rules. It considers the risks of radiation exposure from CT scans for children and how to balance these risks with clinical need.
Children at very low risk of brain injuriesSun Yai-Cheng
Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study
Lancet 2009; 374: 1160–70
This document discusses various types of facial trauma and fractures. It provides details on examining and evaluating patients with facial trauma, including important physical exam findings. It also reviews specific fractures like orbital fractures, LeFort fractures, mandibular fractures, and nasal bone fractures. Radiographic signs of facial fractures and emergency management of airway and hemorrhage are also covered.
The document provides guidance on interpreting x-rays for trauma patients, focusing on the cervical spine, chest, pelvis, maxillofacial region, and wrist/hand. It describes what to look for on each image such as alignment, bone fractures, soft tissue swelling, and anatomical landmarks. Proper visualization and positioning is important to detect injuries and abnormalities like pneumothorax, spine fractures, and bone displacements.
CT is the most important imaging modality for evaluating head trauma. It can detect fractures, extra-axial hemorrhages such as epidural hematomas and subdural hematomas, subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhages. Common primary traumatic brain injuries seen on CT include contusions, diffuse axonal injury characterized by small hemorrhages, and deep cerebral and brainstem injuries. MRI can provide additional details, especially in the subacute and chronic stages.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
1) Pediatric head trauma is a leading cause of death and disability in children, with over 650,000 evaluated per year. The causes vary by age, from abuse and falls in infants/toddlers to motor vehicle crashes and assaults in adolescents.
2) Management involves stabilizing the ABCs, preventing secondary brain injury, and obtaining a CT scan if indicated based on decision rules. For severe injuries, intensive care is needed for ICP monitoring, seizure prophylaxis, and treating complications like hypo/hyperglycemia.
3) While outcomes have improved with specialized pediatric trauma care, severe traumatic brain injury continues to carry high mortality rates around 40% and most survivors have long-term impairments.
This document presents a case of pediatric head injury. It discusses a case of an 11-year-old boy who was unrestrained in a motor vehicle collision and was ejected. He presented with a Glasgow Coma Scale of 4 and required intubation. Imaging showed open skull fractures, brain swelling, and hemorrhages. The document then reviews the epidemiology, pathophysiology, clinical features, decision rules, and management of minor, moderate and severe pediatric head injuries. Special considerations for pediatric head injuries include the increased risk of abuse in young children and anatomical differences that make the skull more vulnerable to injury compared to adults.
Dr Chong Shu Ling - Paediatric head injuryRahul Goswami
The document discusses the management of a 7-year-old girl who presented to the emergency department after being hit by a taxi while crossing the road. On examination, she was crying and oriented but became agitated and drowsy. Her GCS score was assessed and she displayed abnormal flexion in response to pain. The document discusses various clinical decision rules for determining which pediatric patients with head injuries require CT imaging, including the CHALICE, PECARN, and CATCH rules. It considers the risks of radiation exposure from CT scans for children and how to balance these risks with clinical need.
Children at very low risk of brain injuriesSun Yai-Cheng
Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study
Lancet 2009; 374: 1160–70
This document discusses various types of facial trauma and fractures. It provides details on examining and evaluating patients with facial trauma, including important physical exam findings. It also reviews specific fractures like orbital fractures, LeFort fractures, mandibular fractures, and nasal bone fractures. Radiographic signs of facial fractures and emergency management of airway and hemorrhage are also covered.
The document provides guidance on interpreting x-rays for trauma patients, focusing on the cervical spine, chest, pelvis, maxillofacial region, and wrist/hand. It describes what to look for on each image such as alignment, bone fractures, soft tissue swelling, and anatomical landmarks. Proper visualization and positioning is important to detect injuries and abnormalities like pneumothorax, spine fractures, and bone displacements.
CT is the most important imaging modality for evaluating head trauma. It can detect fractures, extra-axial hemorrhages such as epidural hematomas and subdural hematomas, subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhages. Common primary traumatic brain injuries seen on CT include contusions, diffuse axonal injury characterized by small hemorrhages, and deep cerebral and brainstem injuries. MRI can provide additional details, especially in the subacute and chronic stages.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
1. ΤΟ ΤΡΑΥΜΑ ΣΤΑ ΠΑΙΔΙΑ ΑΝΤΙΜΕΤΩΠΙΣΗ ΑΠΟ ΤΟΥΣ ΠΑΙΔΟΧΕΙΡΟΥΡΓΟΥΣ Γαβαλάκης Νίκος Παιδοχειρουργική Κλινική «Τζάνειο» Νοσοκομείο
2.
3.
4.
5.
6. Εκτίμηση της επάρκειας της αναπνοής Προσπάθεια αναπνοής Εισολκές Αναπνευστική συχνότητα Εισπνευστικοί και εκπνευστικοί ήχοι Γογγυσμός Χρήση επικουρικών μυών Αναπέταση ρωθώνων Δύναμη αναπνοής Αναπνευστικό ψιθύρισμα Έκπτυξη του πνεύμονα Κοιλιακή έκπτυξη Αποτελέσματα ανεπαρκούς αναπνοής Καρδιακή συχνότητα Χρώμα δέρματος Επίπεδο Συνείδησης