Polytrauma in children


Paediatric polytrauma is a life-threatening condition that can happen in practice to any doctor. In our algorithm we modelled a situation, where we will show step by step how to act in this cases. We will focus on first aid at the scene of an accident, how to proceed with a developed hypovolemic shock and life-threatening bleeding and subsequently we will focus on how damage control surgery in paediatric polytraumas is carried out.

2022
Polytrauma
car accident
children
bleeding
damage control surgeryPolytrauma
car accident
children
bleeding
damage control surgery
Published at: 18.7.2022

Review

Michal Frelich, MD, PhD
Physician, Department of the Anaesthesia, Resuscitation and Intensive Care Medicine, University Hospital Ostrava and Faculty of Medicine Ostrava University, Ostrava, Czech Republic. Physician, Emergency Medical Service of the Moravian-Silesian region, Czech Republic.

Polytrauma is defined as an injury to two or more body systems, of which at least one injury or a combination threatens the patient with failure of vital functions. Severe injury is a significant cause of morbidity in childhood and the most common cause of death in children older than one year. Traumatic death in children is most commonly caused by severe craniocerebral injury and/or massive blood loss. From the perspective of saving a child's life, early and adequate treatment is the key, at all levels of the chain of survival, from pre-hospital emergency care and emergency admission to the operating room and intensive care unit. The presented algorithm reflects this fact and accompanies us through all levels of care for a severely injured child. Among other things, it emphasizes the role of first aid provided by witnesses of an accident, when stopping the extensive external bleeding, even with improvised means, is a life-saving performance. The universal ABCDE algorithm, early detection and treatment of life-threatening injuries, applies to all stages of treatment and is very clearly applied to clinical practice in the presented case scenario.
 

Sources

MALÁSKA, Jan, Jan STAŠEK, Milan KRATOCHVÍL and Václav ZVONÍČEK. Intenzivní medicína v praxi. Praha: Maxdorf, [2020]. Jessenius. ISBN 978-80-7345-675-7.

VAN DE VOORDE Patrick, TURNER Nigel M., DJAKOW Jana, DE LUCAS Nieves, MARTINEZ-MEJIAS Abel, BIARENT Dominique, BINGHAM Robert, BRISSAUD Oliver, HOFFMANN Florian, JOHANNESDOTTIRL Groa Bjork, LAURITSEN Torsten, MACONOCHIE Ian. European Resuscitation Council Guidelines 2021: Paediatric Life Support. ERC Guidelines [online]. Copyright ©,e [cit. 11.04.2022]. Available at: https://www.cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Pa.pdf

ZIDEMAN David A., SINGLETARY Eunice M., BORRA Vere, CASSAN Pascal, CIMPOESU Carmen D., DE BUCK Emmy, DJARY Therese, HANDLEY Anthony J., KLAASSEN Barry, MEYRAN Daniel, OLIVER Emily, POOLE Kurtis. European Resuscitation Council Guidelines 2021: First aid. ERC Guidelines [online]. Copyright © [cit. 11.04.2022]. Available at: https://www.cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Fi.pdf

LEIBNER Evan, ANDREAE Mark, GALVAGNO Samuel M. Jr., SCALEA Thomas. Damage control resuscitation [online], 2020.[cit. 11.04.2022] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141982/

SPAHN Donat R., BOUILLON Bertil, CERNY Vladimir, DURANTEAU Jacques, FILIPESCU Daniela, HUNT Beverley J., KOMADINA Radko, MAEGELE Marc, NARDI Giuseppe, RIDDEZ Louis, SAMAMA Charles-Marc, VINCENT Jean-Louis, ROSSAINT Rolf. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition [online], 2019. [cit. 11.04.2022]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436241/pdf/13054_2019_Article_2347.pdf

FRELICH Michal et al . Dětské polytrauma. Praha: Grada Publishing, 2022. ISBN: 978-80-271-2561-6

Related algorithms

Algorithms