The child with multiple injuries: resuscitation priorities

The child with multiple injuries frequently presents with airway compromise, hypovolemia, and central nervous system injury. These often result in shock, a state characterized by inadequate delivery of oxygen to tissues. Signs of shock are more subtle in children. Recognition of shock is importait because it is the final common pathway leading to death. Treatment begins with establishing a patent airway, and attaining adequate oxygenation and ventilation. Aggressive resuscitation, with large fluid boluses, is imperative. Once the child is hemodynamically stable, the CT scan aids in the diagnosis and management of head, chest, and abdominal trauma. Non-operative treatment of splenic and hepatic injuries is increasingly favored with excellent outcome. To ensure a smooth and complete evaluation of the injured child, a predetermined protocol and an interdisciplinary approach are essential.