Pediatric Trauma—Not Just Little Adults—Part 1: Differences in Physiology and Injury Patterns

Mikrogianakis A, Grant V. The kids are alright: pediatric trauma pearls. Emerg Med Clin North Am. 2018;36(1):237–57. https://doi.org/10.1016/j.emc.2017.08.015.

Article  PubMed  Google Scholar 

West BA, Rudd RA, Sauber-Schatz EK, Ballesteros MF. Unintentional injury deaths in children and youth, 2010–2019. J Safety Res. 2021;78:322–30. https://doi.org/10.1016/j.jsr.2021.07.001.

Article  PubMed  Google Scholar 

• Khalil M, Alawwa G, Pinto F, O’Neill PA. Pediatric mortality at pediatric versus adult trauma centers. J Emerg Trauma Shock. 2021;14(3):128–35. https://doi.org/10.4103/jets.Jets_11_20. The study highlights the critical importance of pediatric-specific care in trauma outcomes, suggesting that pediatric trauma centers are more effective in reducing mortality rates for injured children.

Article  PubMed  PubMed Central  Google Scholar 

• Kennedy AP, Scorpio RJ, Coppola CP. Assessment of the pediatric trauma patient: differences in approach. J Emerg Crit Care Med. 2018. https://doi.org/10.21037/jeccm.2018.01.01. This article emphasizes that children have unique anatomical and physiological characteristics that necessitate specialized assessment techniques. The authors highlight the importance of recognizing age-specific injury patterns, using pediatric-specific diagnostic tools, and employing a child-centered approach to improve the accuracy of assessments and the effectiveness of subsequent treatments. This tailored approach is crucial for optimizing outcomes and minimizing long-term impacts of trauma in pediatric patients.

Article  Google Scholar 

Acker SN, Kulungowski AM. Error traps and culture of safety in pediatric trauma. Semin Pediatr Surg. 2019;28(3):183–8. https://doi.org/10.1053/j.sempedsurg.2019.04.022.

Article  PubMed  Google Scholar 

Nakayama DK, Burd RS, Newman KD. Pediatric surgery workforce: supply and demand. J Pediatr Surg. 2009;44(9):1677–82. https://doi.org/10.1016/j.jpedsurg.2009.03.036.

Article  PubMed  Google Scholar 

Sathya C, Alali AS, Wales PW, Scales DC, Karanicolas PJ, Burd RS, et al. Mortality among injured children treated at different trauma center types. JAMA Surg. 2015;150(9):874–81. https://doi.org/10.1001/jamasurg.2015.1121.

Article  PubMed  Google Scholar 

Guyther J, Wiltjer R. Pediatric trauma. Emerg Med Clin North Am. 2023;41(1):205–22. https://doi.org/10.1016/j.emc.2022.09.002.

Article  PubMed  Google Scholar 

Walther AE, Falcone RA, Pritts TA, Hanseman DJ, Robinson BR. Pediatric and adult trauma centers differ in evaluation, treatment, and outcomes for severely injured adolescents. J Pediatr Surg. 2016;51(8):1346–50. https://doi.org/10.1016/j.jpedsurg.2016.03.016.

Article  PubMed  PubMed Central  Google Scholar 

•• Moore L, Freire G, Turgeon AF, Bérubé M, Boukar KM, Tardif PA, et al. Pediatric vs adult or mixed trauma centers in children admitted to hospitals following trauma: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(9): e2334266. https://doi.org/10.1001/jamanetworkopen.2023.34266.Annotation: The authors demonstrate that pediatric trauma patients treated at specialized pediatric trauma centers have better survival rates and outcomes compared to those treated at adult or mixed trauma centers. This underscores the critical need for pediatric-specific trauma care to optimize treatment and recovery for injured children.

Article  PubMed  PubMed Central  Google Scholar 

Miyata S, Cho J, Lebedevskiy O, Matsushima K, Bae E, Bliss DW. Trauma experts versus pediatric experts: comparison of outcomes in pediatric penetrating injuries. J Surg Res. 2017;208:173–9. https://doi.org/10.1016/j.jss.2016.09.040.

Article  PubMed  Google Scholar 

Kenefake ME, Swarm M, Walthall J. Nuances in pediatric trauma. Emerg Med Clin North Am. 2013;31(3):627–52. https://doi.org/10.1016/j.emc.2013.04.004.

Article  PubMed  Google Scholar 

Overly FL, Wills H, Valente JH. ’Not just little adults’—a pediatric trauma primer. R I Med J. 2014;97(1):27–30.

Google Scholar 

Narotam PK, Burjonrappa SC, Raynor SC, Rao M, Taylon C. Cerebral oxygenation in major pediatric trauma: its relevance to trauma severity and outcome. J Pediatr Surg. 2006;41(3):505–13. https://doi.org/10.1016/j.jpedsurg.2005.11.069.

Article  PubMed  Google Scholar 

Woosley CR, Mayes TC. The pediatric patient and thoracic trauma. Semin Thorac Cardiovasc Surg. 2008;20(1):58–63. https://doi.org/10.1053/j.semtcvs.2008.02.002.

Article  PubMed  Google Scholar 

Rose E, Claudius I. Pediatric critical care. Emerg Med Clin North Am. 2014;32(4):939–54. https://doi.org/10.1016/j.emc.2014.07.013.

Article  PubMed  Google Scholar 

Lowe CG, Campwala RT, Ziv N, Wang VJ. The Broselow and Handtevy resuscitation tapes: a comparison of the performance of pediatric weight prediction. Prehosp Disaster Med. 2016;31(4):364–75. https://doi.org/10.1017/s1049023x16000455.

Article  PubMed  Google Scholar 

Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL Jr, et al. Part 4: pediatric basic and advanced life support: 2020 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16 suppl 2):S469-523. https://doi.org/10.1161/cir.0000000000000901.

Article  PubMed  Google Scholar 

Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth. 2009;103(6):867–73. https://doi.org/10.1093/bja/aep290.

Article  CAS  PubMed  Google Scholar 

de Wit M, Peelen LM, van Wolfswinkel L, de Graaff JC. The incidence of postoperative respiratory complications: a retrospective analysis of cuffed vs uncuffed tracheal tubes in children 0–7 years of age. Paediatr Anaesth. 2018;28(3):210–7. https://doi.org/10.1111/pan.13340.

Article  PubMed  Google Scholar 

Sarganas G, Schaffrath Rosario A, Berger S, Neuhauser HK. An unambiguous definition of pediatric hypotension is still lacking: gaps between two percentile-based definitions and pediatric advanced life support/advanced trauma life support guidelines. J Trauma Acute Care Surg. 2019;86(3):448–53. https://doi.org/10.1097/ta.0000000000002139.

Article  CAS  PubMed  Google Scholar 

Greene N, Bhananker S, Ramaiah R. Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma. Int J Crit Illn Inj Sci. 2012;2(3):135–42. https://doi.org/10.4103/2229-5151.100890.

Article  PubMed  PubMed Central  Google Scholar 

Galvagno SM Jr, Nahmias JT, Young DA. Advanced Trauma Life Support(®) update 2019: management and applications for adults and special populations. Anesthesiol Clin. 2019;37(1):13–32. https://doi.org/10.1016/j.anclin.2018.09.009.

Article  PubMed  Google Scholar 

Perea LL, Moore K, Docherty C, Nguyen U, Seamon MJ, Byrne JP, et al. Whole blood resuscitation is safe in pediatric trauma patients: a multicenter study. Am Surg. 2023;89(7):3058–63. https://doi.org/10.1177/00031348231157864.

Article  PubMed  Google Scholar 

Anand T, Obaid O, Nelson A, Chehab M, Ditillo M, Hammad A, et al. Whole blood hemostatic resuscitation in pediatric trauma: a nationwide propensity-matched analysis. J Trauma Acute Care Surg. 2021;91(4):573–8. https://doi.org/10.1097/ta.0000000000003306.

Article  PubMed  Google Scholar 

Nuttall AG, Paton KM, Kemp AM. To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions. BMJ Open. 2018;8(11): e023216. https://doi.org/10.1136/bmjopen-2018-023216.

Article  PubMed  PubMed Central  Google Scholar 

Dudley N, Ackerman A, Brown KM, Snow SK. Patient- and family-centered care of children in the emergency department. Pediatrics. 2015;135(1):e255–72. https://doi.org/10.1542/peds.2014-3424.

Article  PubMed  Google Scholar 

Kassam-Adams N, Butler L, Price J, Gawel M, Graham L, Myers S, et al. Trauma-informed and family-centered paediatric resuscitation: defining domains and practices. Resusc Plus. 2023;14: 100374. https://doi.org/10.1016/j.resplu.2023.100374.

Article  PubMed  PubMed Central  Google Scholar 

Sanchez Cristal N, Staab J, Chatham R, Ryan S, McNair B, Grubenhoff JA. Child life reduces distress and pain and improves family satisfaction in the pediatric emergency department. Clin Pediatr (Phila). 2018;57(13):1567–75. https://doi.org/10.1177/0009922818798386.

Article  PubMed  Google Scholar 

Bućko E, Sosnowska-Sienkiewicz P, Lebioda P, Mańkowski P. The management of pediatric patient with head injury in an adult-oriented emergency department. Pol Przegl Chir. 2022;95(2):1–5. https://doi.org/10.5604/01.3001.0015.8206.

Article  PubMed  Google Scholar 

Ryan ME, Pruthi S, Desai NK, Falcone RA Jr, Glenn OA, Joseph MM, et al. ACR Appropriateness Criteria® head trauma-child. J Am Coll Radiol. 2020;17(5s):S125–37. https://doi.org/10.1016/j.jacr.2020.01.026.

Article  PubMed  Google Scholar 

Kissoon N, Dreyer J, Walia M. Pediatric trauma: differences in pathophysiology, injury patterns and treatment compared with adult trauma. CMAJ. 1990;142(1):27–34.

CAS  PubMed  PubMed Central  Google Scholar 

Thomas DG, Apps JN, Hoffmann RG, McCrea M, Hammeke T. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015;135(2):213–23. https://doi.org/10.1542/peds.2014-0966.

Article  PubMed  Google Scholar 

Carek SM, Clugston JR. Acute sports-related head injuries. Prim Care. 2020;47(1):177–88. https://doi.org/10.1016/j.pop.2019.10.010.

Article  PubMed  Google Scholar 

Lawrence DW, Richards D, Comper P, Hutchison MG. Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion. PLoS ONE. 2018;13(4): e0196062. https://doi.org/10.1371/journal.pone.0196062.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Konovalov N, Peev N, Zileli M, Sharif S, Kaprovoy S, Timonin S. Pediatric cervical spine injuries and SCIWORA: WFNS spine committee recommendations. Neurospine. 2020;17(4):797–808. https://doi.org/10.14245/ns.2040404.202.

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