Enfant polytraumatisé

Trauma is the leading cause of both morbidity and mortality in the paediatric population. Early and aggressive management may improve survival and functional outcome. In children with multiple traumas, optimal care includes adequate initial assessment, aggressive resuscitation and conservative surgical management as often as possible. Acute respiratory failure is frequent in trauma paediatric patients and endotracheal intubation should be performed without delay. Haemorrhage is the leading cause of circulatory failure. Resuscitative fluids and vasoactive drugs, if needed, are given before possible surgical control of haemorrhage. Since severe head trauma is preponderant in this population, one of the major goals of initial critical care management is aimed at preventing secondary brain damage, especially hypoxia and hypotension. Improvement in diagnosis imaging represents a crucial advance in paediatric trauma care, with ultrasonography used as first line investigation, and CT scanning as the gold standard in stabilised and adequately monitored children. This effective management should decrease mortality and morbidity of severe trauma.