Pediatric trauma: need for surgical management.
A recent proposal by some pediatricians is that they be primarily responsible for resuscitation and triage of injured children with surgical care being initiated only through consultation. To assess the need for operative intervention, a consecutive series of 376 children less than 15 years of age admitted to a regional trauma center was examined, in which 194 children had 254 operations. Mortality was 7.2%. Twenty-two children who presented with persistent hemodynamic instability (sys. BP less than 90 mm Hg) had a mortality of 73%. Children were divided into three severity groups based on the Revised Trauma Score (RTS). Of the severely injured children (RTS less than or equal to 6), 79% required emergent operative intervention; 42% and 14%, respectively, required emergent operation in the moderately (6 less than RTS less than 12) and minimally (RTS = 12) injured groups. The need for operative management is great, even in "minimally" injured children.
Department of Surgery, University of Washington, Seattle.
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Kaufmann
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Rivara
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Maier
D002648:Child; D004630:Emergencies; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D011379:Prognosis; D012151:Resuscitation; D014218:Triage; D014947:Wounds and Injuries / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery