pediatric blunt abdominal trauma ppt

EAU guidelines 2018 American Association for the Surgery of Trauma (AAST) Campbell and Walsh Urology 101h edition 00 Pediatric sports injuries, including those from baseball, include mainly musculoskeletal injuries and rarely blunt abdominal injuries. Blunt torso injury in children Head and Thoracic are the most common. Cardiac rupture following thoracic or abdominal trauma is relatively unknown and rarely reported in the pediatric trauma literature. Tranexamicacid administration to pediatric trauma patients in a combat setting: The pediatric trauma and tranexamicacid study (PED_TRAX). Periportal tracking in pediatric blunt abdominal trauma ... •To get TXA needed severe abdominal or extremity injury and base deficit greater than 5. Pediatric Blunt Trauma | Major Trauma | Traumatology Nonoperative management of pediatric blunt abdominal injury has changed significantly in the last few years. 2009 Jun. Pediatric Nonaccidental Abdominal Trauma: What the ... 2 - ABDOMINAL TRAUMA.ppt - ABDOMINAL TRAUMA By Dr Saleh M ... Car) •Lower extremity fx, thoracic/upper abdominal trauma/head trauma •Bike accident •Head/ortho •Handlebar injuries-shearing of abdominal wall away from skin (handlebar hernia), pancreas and duodenal injuries •MVA with lap belt worn too high seat belt injury Limiting chest computed tomography in the evaluation of pediatric thoracic trauma. PDF The Use of a Pediatric Abdominal Trauma Protocol Improves ... PDF Trauma Guidelines - Home | Stanford Medicine PDF Pediatric Trauma Lecture June 6 2013[1] Acad Emerg Med. PDF Splenic trauma: WSES classification and guidelines for ... • 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 Chest x-ray as a screening tool for blunt thoracic trauma in children. The kidney is the most commonly injured organ in the urinary tract, followed by the bladder, urethra, and ureter. Christiano JG, Tummers M, Kennedy AP. Trauma in neonates represents a rare but unique diagnostic challenge since shock and abdominal rigidity or altered mental status may be the only indications of underlying abdominal injury [ 2 ]. 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 . 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. Christiano JG, Tummers M, Kennedy A. •Recommended with first 3 hours 89 (55%) received FAST scans prior to the - 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 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 . Pediatric Trauma: the Problem • Trauma leading cause of death > 1 year . Abdominal and Genitourinary Trauma Steve Lan September 25, 2003 Abdominal Trauma Anatomy History/Examination Investigations Blunt Trauma Penetrating Trauma Principles . - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 4cf199-OGM4Y Serum amylase determination and blunt abdominal trauma. Improved resource utilization in the diagnosis of pediatric abdominal injury has been described. The advantages and disadvantages of abdominal ultrasound are listed in Box 20-3 . Test characteristics of focused assessment of sonography for trauma for clinically significant abdominal free fluid in pediatric blunt abdominal trauma. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. 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 . Although the incidence of death from these injuries remains low, a missed injury can have a devastating outcome. Chest wall b. Thoracic great vessels c. Heart, lungs, pleura d. Diaphragm, esophagus e. Trachea and bronchus 6. 5th ed. Lab Monitoring and Prognosis in Pediatric Trauma 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, PECARN's (Pediatric Emergency Care Applied Research Network) prediction rule to identify children with blunt abdominal trauma who are very low risk for clinically important intra-abdominal injuries. and negative predictive values of FAST scans in detecting intra-abdominal injury following blunt trauma. Liang T, Roseman E, Gao M, Sinert R. The Utility of the Focused Assessment With Sonography in Trauma Examination in Pediatric Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis. Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. adults and children must be different, children should always be treated in dedicated pediatric trauma centers. 98-101 Ultrasound may fail to detect grades 3 and 4 hepatic lacerations and grades 2 and 3 splenic lacerations, especially if the associated bleeding is not brisk . Blunt Abdominal Trauma 60 Blunt Splenic Trauma 61-62 Blunt Bowel and Mesenteric Injury 63-64 Rectal Injury 65 Pelvic Fracture 66-67 . Lab Monitoring and Prognosis in Pediatric Trauma 20 In hemodynamically stable patients with blunt abdominal trauma, FAST has a sensitivity of 42-100%. treatment depends on extent of trauma. Pediatric Abdominal Trauma Third leading cause of pediatric traumatic death Blunt causes in 85%, penetrating trauma in 15% Blunt trauma related to MVC's causes more than 50% of abdominal injuries in children . Trauma is the leading cause of morbidity and mortality in the pediatric population. Management of Pediatric Blunt Renal Trauma20 Years of Experience Dangle PP, Fuller TW, Gaines B et al. They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. Types of the abdominal trauma. Results There were 482 pediatric trauma calls secondary to blunt trauma over a three year period. In the setting of blunt abdominal trauma, the zones have been attributed to dissection of blood along the portal tracts. Bansal S, Karrer FM, Hansen K, et al. J Trauma. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines. Winner of the Standing Ovation Award for "Best PowerPoint Templates" from Presentations Magazine. mortality rate of ~8.5%. 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 Eckert M. (2014) J trauma acute care surg77:6, pp. Evolving Mechanisms of Injury and. When a pediatric patient presents to the ED following blunt abdominal trauma, the abdominal examination may be unreliable due to the child's age or developmental level, or due to an associated head injury; a negative abdominal examination and the absence of comorbid injuries do not completely . The pediatric trauma score includes six components and is designed to assist with rapid triage of the injured child. The recognition of the mechanism of the injury weather is penetrating or non-penetrating trauma is a greatest importance for treatment and diagnosis and workup therapy. Clinical significance of isolated intraperitoneal fluid on computed tomography in pediatric blunt abdominal trauma. Pediatric abdominal trauma 1. Eckert M. (2014) J trauma acute care surg77:6, pp. •Greater incidence of abdominal, chest and spinal cord injury without fracture High Surface Area/Body Volume = Greater Heat Loss -- THINK TEMPERATURE . 1 Introduction. 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 . The use of ultrasound as a screening modality may lead to false-negative results. Children are also more susceptible to shear injury because their brains are less myelinated. 2011;18(5):477-482. 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 Pediatric Notes October 2019 110. blunt abdominal trauma. Clinical Significance of isolated intraperitoneal fluid on computed tomography in pediatric blunt abdominal trauma. Its sensitivity ranges from 85% to 99% and its specificity from 97% to 100%. 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. 5 . It is suggested that after initial computerized tomography for accurate staging of pediatric blunt renal trauma monitoring can be performed with ultrasound in most patients (excluding those with hemodynamic instability or deemed to require computerizedtomography for associated injuries), Selective reevaluation with computerizedTomography can be reserved for those with serial or ambiguous . Head injury is the leading cause of death and disability in children. PCH/St. - Demonstrate use of fluid resuscitation in patients with profound blood loss. Pediatric Blunt Spleen/Liver Trauma Management 138-139 Pediatric Blunt Renal Trauma Management 140-141 Pediatric Extremity Fracture 142-143 5) List intra-abdominal injuries that may be missed on CT. 6) Describe the process of local wound exploration. Hemodynamic status, rather than grade of injury, now guides care. Car) •Lower extremity fx, thoracic/upper abdominal trauma/head trauma •Bike accident •Head/ortho •Handlebar injuries-shearing of abdominal wall away from skin (handlebar hernia), pancreas and duodenal injuries •MVA with lap belt worn too high seat belt injury Abdominal trauma is the third leading cause of traumatic death, behind head and thoracic injuries in children. 852-858. Methods. difficult to recognize clear symptoms early. Compared with adults, the pediatric kidney is more vulnerable to injury because there is . Trauma Resuscitation Guidelines . Posted on January 3, 2022. play sega games on android. Abdominal Trauma 38. Get free Power Point Presentation Trauma Surgery and Patient Management, which also includes Abdominal Blunt Trauma and Trauma and Recovery. 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. 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. Pediatric Siadh.pdf April 2020 24. •Recommended with first 3 hours PCH/St. 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. Head Trauma. 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 . External Validation of a Five-variable Clinical Prediction Rule for Identifying Children at Very Low Risk for Intra-Abdominal Injury After Blunt Abdominal Trauma ; Non-operative Management of Solid Organ Injuries in Children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee Systematic Review Duodenal injury is rare among abdominal injuries and accounts for 0.2% to 3.7% of all trauma . Types of the abdominal trauma. Thoracic trauma accounts for ⅓ all trauma admits 5. Abdominal TraumaLook for distension, tenderness, seatbelt marks, penetrating trauma, retroperitoneal ecchymosisBe suspicious of free fluid without evidence of solid organ injury Splenic InjuryMost commonly injured organ in blunt traumaOften associated with other injuriesLeft lower rib pain may be indicativeOften can be managed non . The retroperitoneum is best evaluated by CT. 1,2 Renal injury occurs from trauma to the back, flank, lower thorax, or upper abdomen. The risk of intra-abdominal injuries in pediatric patients with stable blunt abdominal trauma and negative abdominal computed tomography. in blunt trauma Recent study evaluated 1500 consecutive children with blunt abdominal trauma CT findings and decision for operative or non operative management were recorded 388 (26%) of CT scans had abnormal findings 286 solid organ 103 other 30 hollow viscous injury Data regarding embolization in pediatric patients is limited. Journal of Pediatric Surgery, 42, 1588-1594. Abdominal trauma caused by blunt force is a common presentation in the emergency room seen in adults and children. Abdominal trauma can be associated with significant morbidity and may have a mortality as high as 8.5%. Pediatric Abdominal Trauma Yana Puckett, MD 2. Mure AJ, Josloff R, Rothberg J, et al. 2/3 of all intraabdominal injuries. Am Surg 1991; 57:210. In the setting of blunt abdominal trauma, the zones have been attributed to dissection of blood along the portal tracts. Pediatr Emerg Care 2021; 37:108. Holmes, J. 2000 May;48(5):902-6.Holcomb GW III, Murphy JP. 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 . Blunt chest trauma a. 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 . 44(6):1242-8. Recent findings . Pediatric Trauma Data • On average, 9000-13000 children die each year from unintentional injury • Death rates highest from motor vehicle crashes, particularly in the upper Plains • Native American death rate highest among all races • Over 9 million children present to ER each year for injury • More than 16% of admissions for unintentional injury Blunt Trauma Patterns •Waddell's triad (Ped vs. But…Abdominal Injuries are Most Unrecognized Cause of Death. 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. Management of Pediatric Blunt Renal Trauma20 Years of Experience Dangle PP, Fuller TW, Gaines B et al. Abdominal and GU trauma is the leading cause of unrecognized fatal injury in children. Practice Essentials. Focused abdominal sonography for trauma (FAST) in children with blunt abdominal trauma. Children are more susceptible than adults to serious injury secondary to blunt abdominal trauma. Epidemiology. Pediatric injuries differ from adult trauma as the elastic pediatric rib cage may cause a transmission of force into the abdominal compartment . (2010). - Identify and manage abdominal injury in a trauma patient. Pediatric blunt abdominal injuries are mainly caused by traffic accidents and falls, and few cases have been reported in relation to sports injuries. Trauma is the #1 cause of death and disability in children >1 year old. (a) Blunt abdominal trauma. Thoracic injury may involve: a. Penetrating abdominal trauma accounts for approximately 15% of the total cases and 6% of these will die primarily from the penetrating wound. •Greater incidence of abdominal, chest and spinal cord injury without fracture High Surface Area/Body Volume = Greater Heat Loss -- THINK TEMPERATURE . 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 . Pediatric Radiography.ppt December 2019 67. Pediatric Trauma: the Problem • Trauma leading cause of death > 1 year . J Surg Res. None declared. 3. Certain imaging findings in the pediatric abdomen, notably bowel perforation and pancreatic injury, should alert the radiologist to possible abuse and incite close interrogation . Abdominal Trauma 36. In particular, reports of survival are rare.8, 9, 12 These lesions are described most often in autopsy literature, which highlights their morbid character. Ashcrafts Pediatric Surgery. (b) Penetrating abdominal trauma. The purpose of the study was to determine the frequency and significance of periportal tracking identified by CT, and correlate this finding with liver enzyme . Fox JC, Boysen M, Gharahbaghian L, et al. Topics to Discuss • Labs • Diagnostic Modalities -Ultrasound, CT, Laparoscopy • Treatment Modalities -Angiography • Liver and Spleen Management • Pancreas Injury • Renal Injury • Duodenal Injury • Hollow Viscus Injury • Gallbladder Injury • Urinary Bladder Injury • 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 We undertook a retrospective review of a pediatric trauma database from April 2006 to March 2016. - Demonstrate the approach to pediatric trauma: primary and secondary assessment. 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. The chief cause of blunt abdominal trauma in the United States is motor vehicle accidents. It is also the most common unrecognized fatal injury in the pediatric population.. To manage these patients effectively, physicians must be very familiar with children's response to abdominal trauma, recognize important sensory cues and avoid common pitfalls. Abdominal injury in nonaccidental trauma (NAT) is an increasingly recognized cause of hospitalization in abused children. The liver, spleen and kidneys commonly involved in the blunt abdominal injuries. 2016 Aug;81(2):271 -7. Trauma Systems & Trauma Triage: How to take the right patient to the right location at the right time. Philadelphia, PA: Saunders An Imprint of Elsevier, 2010.Lynn KN, Werder GM, Callaghan RM, Sullivan AN, Jafri ZH, Bloom DA. Been reported in relation to sports injuries, including those from baseball, include mainly musculoskeletal injuries and for... 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