Conveyor Belt Entrapment Trauma in Children: An Unreported Menace

A retrospective study was conducted including all the childrenwho sustained motorized machine belt entrapment injuries. Sixchildren included in study had mean (SD) Glosgow coma scaleand pediatric trauma score of 5.7 (3.54) and 3.2 (1.21),respectively. Overall mortality and paraplegia rate were 33.3%each. Awareness and legislation both are important to curb thismenace

Microsurgery in complex trauma of pelvic limb in a pediatric patient: case report

Complex trauma is defined as the condition secondary to the exchange of kinetic energy of two or more tissues in one limb. This entity is a surgical emergency that can have many sequelae and can even result in limb loss. An 11-year-old female patient presents complex pelvic limb trauma secondary to contuse injury caused by a helicopter’s rotor blades.  Pelvic limb reconstruction was performed with iliac crest bone graft, the fracture was stabilized with an external fixator and the skin defect was covered with an anterolateral microvascular thigh flap (ALT). There was an adequate integration of the bone graft with adequate skin coverage thanks to the ALT thigh flap. The patient presented discreet limb shortening as consequence.  Currently, microsurgery is the only medical option that meets the objectives of limb reconstruction. Microsurgical techniques can be used in pediatric and adult patients. The success of any recovery from complex trauma is vigorous surgical cleaning, avoiding sequential and/or multiple washes.

Pediatric traumatic scores / 中国小儿急救医学

Trauma is one of the leading causes of death and disability in children and adolescents. The children with multiple injuries have complicated and varied conditions. This article reviewed the traumatic scores of multiple trauma in pediatric patients. There are many kinds of trauma scores in children,each with advantages and disadvantages,but no trauma scores can meet all clinical and scientific requirements. The current injury severity score is the most widely used in-hospital scoring system. The child trauma score is the easiest pre-hospital scoring system. The BIG score is an emerging simple and easy scoring system. It is recommended that multiple assessments of multiple injuries in children should be repeated and combination of multiple scores are used.

Pattern of Pediatric Trauma in Rural Background of Central India.

Background: Trauma is emerging as an epidemic and a leading cause of morbidity and mortality in children. Children <15 years of age comprise about 32.8% or 1/3th of the total Indian population. In India, up to one-fourth of hospital admissions and approximately 15% of deaths in children are due to injury. The burden of child injuries in India is not clearly known, as there is a lack of proper trauma database in India and even in Indian studies the population covered was metro city based. Aim: The present study aims to analyze the different aspects related to trauma in children particularly from rural background. Materials and Methods: A prospective, observational study was carried out in 510 patients of the age group 0-15 years admitted to the surgical wards of a tertiary care hospital, with a history of trauma during the period from August 2013 to July 2014. Results: Incidence of pediatric trauma was found to be 20.08%. The cases among males were 297 (58.24%) and females were 213 (41.76%) with male:female ratio of 1.39:1. Road traffic accidents (RTA) 32.15% and fall from height (30.78%) were the most common modes of injury. Isolated head injuries 216 (60.5%) were the leading type of injuries. Poly-trauma patients had the highest mortality rates. Conclusion: RTA and fall from height are the most common causes of pediatric trauma. Pediatric trauma and injury are preventable conditions. Educating the health care providers about the pediatric trauma care centers and the establishment of the same at nodal or tertiary care centers is advisable for the proper treatment of pediatric trauma victims. The management of pediatric trauma is specialized teamwork.

Caracterización del trauma pediátrico en un hospital militar de la ciudad de bogotá / Characterization of pediatric trauma in a military hospital of bogotá / Caracterização de trauma pediátrico em um hospital militar na cidade de bogotá

Objetivo: Describir las características sociodemográficas y clínicas de los pacientes entre 0 y 15 años de edad hospitalizados en el 2011 por trauma Pediátrico en el Hospital Militar Central. Métodos: Se realizó un estudio retrospectivo descriptivo en los pacientes pediátricos del Hospital Militar Central de Bogotá, comprendido entre el 1 de enero de 2.011 y 31 de diciembre de 2.011. De un total de 1277 hospitalizados por trauma se tomaron 92 pacientes con edades comprendidas entre los 0 y 15 años de edad, de los cuales precisaron ser ingresados 81 y se incluyeron en la base de datos; con el fin de describir las características epidemiológicas de este grupo de pacientes, determinar la severidad del trauma, y si estuvo relacionado con mortalidad; así como la época del año y el horario con más prevalencia de trauma de la población estudio. Resultados: Se encontró un predominio de trauma en los varones en una relación 1.45:1 siendo el grupo de edad comprendido entre los 11- 15 años el más frecuente, con un total de 21 pacientes (26%). El 71.6% (58 casos) de los ingresos tuvieron un índice de trauma pediátrico de 8 o superior. No encontramos mortalidad asociada al trauma en la casuística estudiada. Conclusiones: El estudio permitió conocer los aspectos sociodemográficos y clínicos de la población pediátrica que se trata en el Hospital Militar Central, y los puntos a intervenir en la institución con el fin de prestar una atención de calidad en la asistencia hospitalaria; así como los posibles factores pronósticos precoces para disminuir la prevalencia de dicha patología.

Objectives: To describe the sociodemographic and clinical characteristics of patients between 0 and 15 years of age hospitalized on 2011 due to a Pediatric trauma within the Hospital Militar Central. Methods: A retrospective descriptive study was performed on pediatric patients of the Hospital Militar Central of Bogota, between January 1, 2011 and December 31, 2011. From a total number of 1277 hospitalized patients due to trauma, 92 patients were taken with ages ranging from 0 to 15 years of age, from which 81 were indicated as admitted and they were included within the database; in order to describe the epidemiological characteristics of this group of patients, by determining the severity of the trauma, and if it was related to mortality; as well as the time of the year and the Schedule with the most prevalence of the trauma of the study population. Results: A predominance was found of trauma on male with a rate of 1.45:1 with the most frequent age group ranging from 11 to 15 years of age, with a total of 21 patients (26%). 71.6% (58 cases) from the admitted patients had a pediatric trauma index of 8 or higher. We did not find mortality associated to trauma within the studied casuistry. Conclusions: The study allowed to recognize the sociodemographic and clinical aspects of the pediatric population that is treated within the Hospital Militar Central, and the points to be intervened within the institution in order to provide a high quality care within hospital assistance; as well as the potential early prognosis to reduce the prevalence of the pathology mentioned before.

Objetivo: Descrever as características sociodemográficas e clinicas dos pacientes entre 0 e 15 anos de idade internados no 2011 por causa do trauma pediátrico no Hospital Militar Central. Métodos: Um estudo retrospectivo e descritivo foi realizado nos pacientes pediátricos do Hospital Central de Bogotá, a partir de 01 de janeiro de 2011 até 31 de Dezembro de 2011. De um total de 1277 internados por trauma, 92 pacientes com idades compreendidas entre 0 e 15 anos de idade foram usados para o estudo, dos quais foi preciso incluir 81 deles na base de dados, com a finalidade de descrever as características epidemiológicas deste grupo de pacientes, determinar a gravidade do trauma e se teve alguma relação com o trauma, além da época do ano com maior prevalência de trauma na população de estudo. Resultados: Uma prevalência de trauma foi encontrada em homens numa proporção 1.45:1, com maior frequência num grupo com idades compreendidas entre os 11 e 15 anos, com um total de 21 pacientes (26%). O 71.6% (58) dos ingressos tiveram um índice de trauma pediátrico de 8 ou superior. Não foi encontrada nenhuma mortalidade associada com trauma dos casos estudados. Conclusões: O estudo permitiu conhecer os aspectos sociodemográficos e clínicos da população pediátrica que está no Hospital Militar Central, bem como os pontos para intervir na instituição com o fim de prover cuidados de qualidade, além dos possíveis fatores prognósticos iniciais para diminuir a prevalência desta patologia.

Initial Stabilization in Severely Injured Child

The often quoted statement that children are not simply small adults remains the central premise of pediatric trauma care. Although multiple traumas remain the leading cause of death among children, fewer resources and less attention have been directed to the treatment of an injured child than to that of an injured adult. Insufficient training of medical personnel and lack of expertise in the management of injured children might be the key factors contributing to the disability and deaths in such children. Although the principles of resuscitation of injured children are similar to those for adults, the basic concepts of advanced life support that have been used for adults remain applicable and critical for injured children. However, we need to know the differences in cardiorespiratory variables, airway anatomy, response to blood loss, and thermoregulation, and special equipments are essential for successful initial resuscitation. Cerebral, abdominal, and thoracic injuries are still the major causes of mortality, morbidity, and disability among traumatized children. Brain parenchymal damage is caused by secondary injuries, such as hypovolemia and hypooxygenemia, are sometimes preventable and intracranial pressure should be maintained within the normal range. The efforts to keep the spleen in children with trauma may make the management of abdominal trauma complicated. Although children seem to be small and weak, our efforts and skill for pediatric life support will make a good result.

The Prognostic Factors in Multiple Traumas in Children

PURPOSE: Trauma is the leading cause of death among children age 1 to 15 years. The initial assessment of injured children is also important for the adequate treatment and transfer of these patients when required. A number of trauma scoring systems have been applied to the pediatric trauma population, with the Pediatric Trauma Score (PTS) being specifically developed as a triage tool for specifically for children. The ability of the PTS to predict the severity of an injury and mortality, and the value of the PTS were evaluated. METHODS: Seventy patients younger than 16 years of age, with multiple organ injuries, were assessed for 5 years, from January 1, 1997 to December 31, 2001. The demographic and clinical variables were retrospectively analyzed and the PTS assessed. RESULTS: Motor vehicle related injuries caused the majority of the multiple organ injuries the children, with liver injuries accounting for the greatest numbers. The survivals showed differences in relation to age, sex, number of injured organs and PTS, but no statistical significance was proved from a univariate analysis. From the multivariated analysis, only the PTS showed statistical significance. There were 5 deaths where the PTS was more than 9 points, was accounting for 55% of all mortalities. CONCLUSION: The PTS is an important triage for injured children, but could not reflect the prognosis of the injured patients when the clinical appearances were not reflected.