Pub Date : 2020-05-01DOI: 10.1093/med/9780190946623.003.0005
Jennifer E. Melvin
Trauma is the most common cause of morbidity and mortality in the pediatric population. Although chest trauma represents less than 10% of all pediatric traumas, it accounts for 14% of all pediatric trauma-related deaths. Thoracic trauma includes injuries to the chest wall, lungs, heart, tracheobronchial tree, diaphragm, and aorta. The most common injuries include pneumothorax, hemothorax, pulmonary contusion, and rib fractures. Sternal fractures occur less commonly and may be seen in cases of isolated or severe chest trauma. Although chest trauma may result from a direct force and therefore result in an isolated injury, when present, it is most often secondary to an extreme mechanism and associated with other clinically significant injuries.
{"title":"Down a Slippery Slope","authors":"Jennifer E. Melvin","doi":"10.1093/med/9780190946623.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780190946623.003.0005","url":null,"abstract":"Trauma is the most common cause of morbidity and mortality in the pediatric population. Although chest trauma represents less than 10% of all pediatric traumas, it accounts for 14% of all pediatric trauma-related deaths. Thoracic trauma includes injuries to the chest wall, lungs, heart, tracheobronchial tree, diaphragm, and aorta. The most common injuries include pneumothorax, hemothorax, pulmonary contusion, and rib fractures. Sternal fractures occur less commonly and may be seen in cases of isolated or severe chest trauma. Although chest trauma may result from a direct force and therefore result in an isolated injury, when present, it is most often secondary to an extreme mechanism and associated with other clinically significant injuries.","PeriodicalId":302677,"journal":{"name":"Pediatric Traumatic Emergencies","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1093/med/9780190946623.003.0012
L. Malia, J. Rabiner
Ankle injuries are a common presentation to the pediatric emergency department, with ankle sprains significantly more common than ankle fractures. This chapter presents a child with a swollen, painful ankle after a sports injury. Evaluation of ankle injuries is discussed, including use of clinical decision rules such as the Ottawa Ankle Rules and the Low Risk Ankle Rule, which help determine who is at low risk for ankle fracture and may not need radiographic imaging. Classification of fractures in children with open physes using the Salter-Harris nomenclature is reviewed. Management of ankle injuries, including bracing, splinting, casting, need for urgent orthopedic consultation, follow-up, and healing are also discussed.
{"title":"Let’s Do the Twist","authors":"L. Malia, J. Rabiner","doi":"10.1093/med/9780190946623.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190946623.003.0012","url":null,"abstract":"Ankle injuries are a common presentation to the pediatric emergency department, with ankle sprains significantly more common than ankle fractures. This chapter presents a child with a swollen, painful ankle after a sports injury. Evaluation of ankle injuries is discussed, including use of clinical decision rules such as the Ottawa Ankle Rules and the Low Risk Ankle Rule, which help determine who is at low risk for ankle fracture and may not need radiographic imaging. Classification of fractures in children with open physes using the Salter-Harris nomenclature is reviewed. Management of ankle injuries, including bracing, splinting, casting, need for urgent orthopedic consultation, follow-up, and healing are also discussed.","PeriodicalId":302677,"journal":{"name":"Pediatric Traumatic Emergencies","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124755908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1093/med/9780190946623.003.0021
E. Berdan, E. A. Woods
The commercial sexual exploitation of children and child sex trafficking are crimes committed against youth. There is a growing body of literature that describes both the detrimental psychological and physical effects of the repeated trauma that occurs as a result of these crimes. Yet huge gaps in education and awareness of sex trafficking exist. Victims/survivors of sex trafficking are seeking healthcare. Can you recognize them? What do you do once you suspect a patient is a victim of sex trafficking?
{"title":"Am I Safe?","authors":"E. Berdan, E. A. Woods","doi":"10.1093/med/9780190946623.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780190946623.003.0021","url":null,"abstract":"The commercial sexual exploitation of children and child sex trafficking are crimes committed against youth. There is a growing body of literature that describes both the detrimental psychological and physical effects of the repeated trauma that occurs as a result of these crimes. Yet huge gaps in education and awareness of sex trafficking exist. Victims/survivors of sex trafficking are seeking healthcare. Can you recognize them? What do you do once you suspect a patient is a victim of sex trafficking?","PeriodicalId":302677,"journal":{"name":"Pediatric Traumatic Emergencies","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132412521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1093/med/9780190946623.003.0018
V. Huang, Nima Jalali, B. McCarty, Philipp J. Underwood
A twelve-year-old boy presents with right wrist pain after a fall onto outstretched hand (FOOSH). The injury was isolated to the right wrist, which was swollen, visibly deformed, but neurovascularly intact distally. Imaging revealed a distal radial and ulna fracture with dorsal displacement. Injuries after a FOOSH include physeal fractures, incomplete fractures, supracondylar fractures, and soft-tissue injuries. Open fractures and neurovascular compromise warrant emergent orthopedic consultation. Displaced fractures should be reduced in the ED and immobilized in a sugar tong splint. Local anesthetics and procedural sedation are important tools to relieve pain and improve patient cooperation. Due to the risks of sedation, physicians should have a systemic approach to evaluate the patient and prepare the monitoring and airway equipment. There are many different medications and routes available. It is important for the physician to be aware of the side effects and discuss this with the patient and parents.
{"title":"FOOSH—OUCH!","authors":"V. Huang, Nima Jalali, B. McCarty, Philipp J. Underwood","doi":"10.1093/med/9780190946623.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780190946623.003.0018","url":null,"abstract":"A twelve-year-old boy presents with right wrist pain after a fall onto outstretched hand (FOOSH). The injury was isolated to the right wrist, which was swollen, visibly deformed, but neurovascularly intact distally. Imaging revealed a distal radial and ulna fracture with dorsal displacement. Injuries after a FOOSH include physeal fractures, incomplete fractures, supracondylar fractures, and soft-tissue injuries. Open fractures and neurovascular compromise warrant emergent orthopedic consultation. Displaced fractures should be reduced in the ED and immobilized in a sugar tong splint. Local anesthetics and procedural sedation are important tools to relieve pain and improve patient cooperation. Due to the risks of sedation, physicians should have a systemic approach to evaluate the patient and prepare the monitoring and airway equipment. There are many different medications and routes available. It is important for the physician to be aware of the side effects and discuss this with the patient and parents.","PeriodicalId":302677,"journal":{"name":"Pediatric Traumatic Emergencies","volume":"156 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131426019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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