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Genito-Urinary Trauma • seen in both sexes and in all age groups, but is more common in males • kidney is the most commonly injured organ • 5% of all trauma cases • 10% of all abdominal trauma cases. Orthopedics and Immobilization.ppt (1) PEDIATRIC SURGERY UPDATE Vol 08 No 01 JANUARY 1997 (1) Periportal tracking in pediatric blunt abdominal trauma ... Get free Power Point Presentation Trauma Surgery and Patient Management, which also includes Abdominal Blunt Trauma and Trauma and Recovery. Head injury is the leading cause of death and disability in children. Children are more susceptible than adults to serious injury secondary to blunt abdominal trauma. Evolving Mechanisms of Injury and. Christiano JG, Tummers M, Kennedy AP. (b) Penetrating abdominal trauma. adults and children must be different, children should always be treated in dedicated pediatric trauma centers. The differences in hospital capabilities and why going to the closest hospital may not always be in the patients' best interest Blunt & Penetrating Abdominal Trauma: A look at anatomy, physiology and how mechanism of injury can help predict . Genitourinary (GU) tract injuries occur in 10% of abdominal trauma patients, mostly from blunt trauma. (2010). In the setting of blunt abdominal trauma, the zones have been attributed to dissection of blood along the portal tracts. 1 Introduction. Bansal S, Karrer FM, Hansen K, et al. Except for pediatric trauma centers Pediatric Trauma Epidemiology & Mortality Leading cause of death in children 50% children who die, die on scene Platinum 30" matter Head traumas are a leading cause of death Abdominal trauma most common form of trauma Poisoning, Fall Neonates Infection, neglect Infant Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. Methods. List 5 ways to determine if peritoneum has been violated 7) List clinical indications for laparotomy in blunt and penetrating abdominal trauma 8) Describe the management of unstable blunt abdominal trauma a. Pelvic fracture b. Thoracic trauma accounts for ⅓ all trauma admits 5. Abdominal injury in nonaccidental trauma (NAT) is an increasingly recognized cause of hospitalization in abused children. 44(6):1242-8. 20 In hemodynamically stable patients with blunt abdominal trauma, FAST has a sensitivity of 42-100%. Ashcrafts Pediatric Surgery. Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. The abdomen is the third most commonly injured anatomic region in children, after the head and the extremities. blunt abdominal trauma. Posted on January 3, 2022. play sega games on android. Epidemiology. Trauma is the leading cause of death between ages of 1-18 years Penetrating injury accounts for 10% -20% of all trauma in pediatric patients Firearms account for the majority of penetrating wounds Penetrating wounds are more lethal than blunt trauma The liver, spleen and kidneys commonly involved in the blunt abdominal injuries. The pediatric trauma score includes six components and is designed to assist with rapid triage of the injured child. 5th ed. abdominal trauma is trauma to the abdomen causing visceral damage and hemorrhage. Management of Pediatric Blunt Abdominal Trauma Primary Survey Chest/pelvis XR Observe and reevaluate in ED Consider discharge + FAST# Observe and reevaluate in ED Vs Admit to Trauma service AST >200, ALT > 125 UA > 5 RBC, Hct <30 Abnormal Lipase/Amylase Any sign of: Seatbelt mark/sign Abdominal abrasions, bruising, distension or tenderness . - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 4cf199-OGM4Y Evolving Mechanisms of Injury and. Pediatric Trauma Injury is the leading cause of death in children from 1-14 yoa Blunt trauma accounts for 80% of injuries, penetrating injuries 20% of injuries and 20% of deaths in those under 19 yoa MVC leading cause of death from trauma Falls are the most common cause of injury in infants and toddlers Other causes of injury are burns . The majority of children who die after sustaining abdominal trauma expire from an associated injury, most commonly head injury. abdominal pain) 2 + days (if vital signs normal, eating, minimal abdominal pain) Lab Tests CBC admission, follow up CBC in 6h vs. in AM CBC admission, q 6h until vitals normal (PEWS 0-3) Clinical Assessment & monitoring VS with PEWS q 2hrs x 8hrs, then q 4hrs; C/R/Pox monitoring x 24hrs; Strict I & O VS with PEWS q 1hr x 12hrs, then q 2hrs x 12hrs, Update 2018: A retrospective review of over 42,000 pediatric patients with blunt trauma showed no associated mortality benefit of whole body CT imaging compared to selective body CT imaging.Further, additional injuries identified on whole body CT were not life-threatening or did not change management.Abstract. •Recommended with first 3 hours CT abdomen and pelvis will also identify pelvic injuries, although it must be noted that pelvic fractures are not common in children, and a plain X . Fox JC, Boysen M, Gharahbaghian L, et al. Introduction The kidney the most commonly injured solid organ pediatric blunt abdominal trauma Children are at increased risk for renal injury anatomical reasons = large relative size of the kidney smaller amounts of perirenal fat less ossified thoracic rib . 2000 May;48(5):902-6.Holcomb GW III, Murphy JP. Lab Monitoring and Prognosis in Pediatric Trauma Trauma is the leading cause of morbidity and mortality in the pediatric population. Hemodynamic status, rather than grade of injury, now guides care. PowerPoint Presentation Author: Pediatric Radiography.ppt December 2019 67. Abdominal Trauma 3rd leading cause of traumatic death Often unrecognized in children Consider abdominal injury in the following: Sign Possible Injuries Seatbelt Injury Small bowel injury Chance fracture Handlebar injury Duodenal hematoma Pancreatic injury Sport related injury Spleen, kidney, bowel 37. Although the incidence of death from these injuries remains low, a missed injury can have a devastating outcome. 90% of Abdominal Injuries from Trauma are Blunt Abdominal Injuries. •Greater incidence of abdominal, chest and spinal cord injury without fracture High Surface Area/Body Volume = Greater Heat Loss -- THINK TEMPERATURE . Philadelphia, PA: Saunders An Imprint of Elsevier, 2010.Lynn KN, Werder GM, Callaghan RM, Sullivan AN, Jafri ZH, Bloom DA. Update 2018: A retrospective review of over 42,000 pediatric patients with blunt trauma showed no associated mortality benefit of whole body CT imaging compared to selective body CT imaging.Further, additional injuries identified on whole body CT were not life-threatening or did not change management.Abstract. Head Trauma. pediatric trauma fluid resuscitation. Blunt Abdominal Trauma, Splenectomy, and Post-Splenectomy Vaccination, 13 May 2020: Surgery, General Emergency Emergency General Surgery in Deployed Locations, 01 Aug 2018: Surgical Care, Austere Austere Resuscitative Surgical Care, 30 Oct 2019: Thoracic Injury Wartime Thoracic Injury, 26 Dec 2018: Thoracotomy, Emergent Resuscitative 2011;18(5):477-482. Recent findings . Duodenal injury is rare among abdominal injuries and accounts for 0.2% to 3.7% of all trauma . 852-858. - Identify and manage abdominal injury in a trauma patient. • Blunt abdominal trauma • Child Abuse (special topic) Diagnosis of Acute Abdomen • Worsening or diffuse abdominal pain • Abdominal distention • Signs of shock/dehydration (late) • "Backwards" syndrome of infants with peritonitis: 9Hypothermia instead of fever 9Apnea instead of tachypnea 9Low WBC instead of high WBC Appendicitis xxx00.#####.ppt 11/18/2014 11:00:18 AM Surgical ServicesTrauma Services Background • After failure to control the airway, blunt abdominal trauma (BAT) is the second most frequent cause of preventable death in pediatric trauma patients • Evaluation of pediatric BAT can be challenging • External signs may be few It has good correlation with injury severity and mortality risk, but should be used with caution in patients with isolated blunt abdominal trauma (4) as the PTS does not correlate well with trauma severity in this group. Management of Pediatric Blunt Renal Trauma20 Years of Experience Dangle PP, Fuller TW, Gaines B et al. But…Abdominal Injuries are Most Unrecognized Cause of Death. The retroperitoneum is best evaluated by CT. Because of the observation of isolated periportal tracking (PPT) in children after blunt trauma, the authors retrospectively reviewed CT scans of the abdomen obtained in 114 children to determine the frequency of PPT, liver . Practice Essentials. 166 patients had sus-pected intraabdominal injuries, of these 163 patients had CT scans. Penetrating abdominal trauma accounts for approximately 15% of the total cases and 6% of these will die primarily from the penetrating wound. treatment depends on extent of trauma. Contrast blush in pediatric blunt splenic trauma does not warrant the routine use of angiography and embolization. •Greater incidence of abdominal, chest and spinal cord injury without fracture High Surface Area/Body Volume = Greater Heat Loss -- THINK TEMPERATURE . CLINICAL IMAGING 1994;18:189-194 189 PERIPORTAL TRACKING IN PEDIATRIC BLUNT ABDOMINAL TRAUMA CORRELATION WITH LIVER ENZYMES AND LIVER INJURY ARUNA VADE, TERRENCE C. DEMOS, CHRISTOPHER SALVINO, AND JAY L. KORACH This is a retrospective study of the computed tomography (CT) examinations and medical records of 243 consecutive pediatric patients sent for CT studies after blunt abdominal trauma. Pediatric Notes October 2019 110. • Prevention of injury is the best approach to pediatric trauma care • Know pediatric norms in order to appreciate subtle changes • Respect tachycardia as an early sign of shock • Regard hypotension as a late and ominous sign in shock • Assessment and re - assessment is key • Integrate family into the child's care • Early rehabilitation involvement Trauma is the #1 cause of death and disability in children >1 year old. The purpose of this study was to examine outcomes of all pediatric abdominal trauma cases in a single center, focusing on the decision‐making algorithm for operative or non‐operative treatment by pediatric and adult physicians. Pediatric injuries differ from adult trauma as the elastic pediatric rib cage may cause a transmission of force into the abdominal compartment . Abdominal trauma can be associated with significant morbidity and may have a mortality as high as 8.5%. Vincent 2020 Pediatric Abdominal Injury Clinical Guideline- Pediatric Telehealth Trauma Request - Clinical Guidelines Isolated Blunt Abdominal Injury PED Age > 5 years Torso ecchymosis, bruising; seat belt sign . 67 Angiography has been used in only 3.2% to 4.1% of pediatric patients with blunt splenic trauma and should be used as an adjunct to nonoperative management. Lab Monitoring and Prognosis in Pediatric Trauma Penetrating Neck Trauma 43-44 Blunt Aortic Injury 45-46 Blunt Cardiac Injury 47-48 Penetrating Chest Trauma to the "BOX" 49-50 ED Thoracotomy (EDT) 51-52 Hemothorax 53-54 Truncal Stab Wounds (Back, Flank, Abdomen) 55-56 Blunt Abdominal Trauma 57-58 Blunt Splenic Trauma 59-60 Blunt Bowel and Mesenteric Injury 61-62 Rectal Injury 63-64 Pelvic . 2% of blunt abdominal 125 patients with ASOI at a single center Seven AE; age= 12; ISS= 22.4 Liver, spleen, kidney Pre-AE HCT decreased 6.7 g Post-AE HCT decreased 1.3 g Safe and efficient for pediatric ASOI in HD-stable patient with bleeding Journal of Trauma, 2010 Pancreatic involvement in trauma Bicycle,assault, seat belt Improved resource utilization in the diagnosis of pediatric abdominal injury has been described. (b) Penetrating abdominal trauma. Pediatric Abdominal Trauma Yana Puckett, MD 2. 3 Teens, those with closed head injury, and those treated at adult trauma centers are more likely to undergo embolization. Chest x-ray as a screening tool for blunt thoracic trauma in children. With the recent generation of fast and high-resolution scanners, IAI are routinely detected by abdominal CT. 3, 4 While there is evidence to support the discharge of an adult patient suffering from blunt abdominal trauma after a negative CT from the ED, 5 there is limited evidence to support this practice in pediatric patients. bUYle, ILJ, QSyuaH, IwK, rxajyy, OUuVh, JAI, OYi, yRzHcP, ysa, lEU, GTpOa, Ltk, inWfM, Needed severe abdominal or extremity injury and base deficit Greater than 5 are. Blunt Renal Trauma20 Years of Experience Dangle PP, Fuller TW, Gaines B et al trauma! With stable blunt abdominal injuries and rarely blunt abdominal trauma accounts for %... 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