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13 Sept 2023 • 'Child is not a young adult', by this fundamental statement Dr. Ashima tried to emphasize that trauma management should be approached differently from that of an adult.🤕
Injury remains the most common cause of death and disability in children, hence one needs to evaluate and manage trauma in this age group carefully.
- First and foremost, a quick history should be taken to understand the mechanism of the injury, followed by the evaluation of the GCS according to the scale corresponding to the child's age group.
- During physical examination, one should also assess the milestones consistent with the child's age and as in any primary survey, the child should be evaluated for ABC
- The cervical spine should be stabilised either with a neck collar or at least by placing a folded towel placed under the child's neck.
- Assess vital signs and evaluate for the shock and the type of shock.
- Manage airway initially with a NRBM on 10L of oxygen and subsequently secure the airway with supraglottic airway or intubation.
- Perform a needle cricothyroidotomy if intubation is not possible.
- Consider intraosseous infusion if peripheral IV access cannot be established and choose the appropriate fluid regimen.
- Expose the patient for injures which are not visible and log roll for spinal injuries.
- Primary survey adjuvants like CXR, pelvic X-ray, ABG, orogastric tube and foley's catheter have to be considered.
Dr. Ashima advises us to remember the mnemonic 'MIST' in the assessment of pediatric trauma
M - Mechanism of Injury I - type of Injury S - Signs and Symptoms T - Treatment given prior to bringing the child to the ED
Click here to learn more about The Primary Evaluation of Pediatric Trauma with Dr. Ashima Sharma.