Evaluation and management of moderate to severe pediatric head trauma.
A case of pediatric head trauma is presented with a detailed discussion of current concepts in evaluation and treatment. Management of the moderate to severe head-injured child is reviewed, and best practices for emergency department treatment are discussed.


BACKGROUND
Pediatric head trauma is a common and potentially devastating injury. Thorough knowledge of the clinical evaluation and treatment will assist the emergency physician in providing optimal care.


CONCLUSIONS
Using a case-based scenario, the initial management strategies along with rationale evidence-based treatments are reviewed.


CONCLUSIONS
Computed tomography scan is the diagnostic test of choice for the moderate to severe head-injured pediatric patient. Several unique scales to describe and prognosticate the head injury are discussed, although currently, the Glasgow Coma Scale is still the most commonly accepted one. Similar to the adult patient, avoidance of hypotension and hypoxia are key to decreasing mortality. Etomidate and succinylcholine remain the choice of medications for intubation. Hyperventilation should be avoided.
Swaminathan
Anand
A
New York University/Bellevue Emergency Medicine Residency, Department of Emergency Medicine, NYU Medical Center, New York, New York, USA.
Levy
Phil
P
Legome
Eric
E
D000058:Accidental Falls; D006259:Craniocerebral Trauma / Q000628:therapy*; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index