EVALUATION AND MANAGEMENT OF PEDIATRIC MAJOR TRAUMA - 09/09/11

Doi : 10.1016/S0733-8627(05)70357-6

Richard M. Cantor, MD, FAAP, FACEP ^a,^b, James M. Leaming, MD ^a

^a Department of Emergency Medicine, The State University of New York Health Science Center (RMC, JML)

^b University Hospital (RMC), Syracuse, New York

Résumé

One half of all deaths in children aged from 1 to 14 years are the result of accidents^{13 Corey T.S. Infant deaths due to unintentional injury: An 11-year autopsy review Am J Dis Child 1992 ; 146 : 968

Cliquez ici pour aller à la section Références, 37 Peclet M.H., Newman K.D., Eichelberger M.R. , et al. Patterns of injury in children J Pediatr Surg 1990 ; 25 : 85-91 [cross-ref]

Cliquez ici pour aller à la section Références}; 15,000 deaths per year are accounted for within this population. More than one half of these mortalities are directly related to motor vehicle accidents.^{3 Agran R.A., Dunkle D.E. Motor vehicle occupant injuries to children in crash and non crash events Pediatrics 1982 ; 70 : 993-996

Cliquez ici pour aller à la section Références} The highest occurrence of death is at 8 years, with accidents accounting for approximately 30% of infant deaths. Nationwide estimates of mortality for children hospitalized after accidents are uniformly low; however, it is wise to take into account that most fatalities in the field occur before arrival at a health care facility. This finding contributes to an underestimation of the magnitude of mortality figures in general.

Patterns of injury help contribute to mortality factors. The most common single organ system injury associate with death in injured children is head trauma. Mortality rates of 80% have been reported in patients with combined thoracoabdominal injuries. The emergency physician is charged with the challenge of evaluating the entire organ system complement in any injured child, regardless of the actual mechanism of injury.^{19 Furnival R.A. Delayed diagnosis of injury in pediatric trauma Pediatrics 1996 ; 98 : 56-62

Cliquez ici pour aller à la section Références}

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Plan

Address reprint requests to Richard M. Cantor, MD, FAAP, FACEP, State University of New York, Health Science Center, Department of Emergency Medicine, 750 East Adam Street, Syracuse, NY 13210