A pediatric trauma surgery is any type of surgical procedure that deals with a traumatic injury that is suffered by an infant, child or young adolescent. Special expertise is required for performing pediatric trauma surgery as the physiological and anatomical design of a child and an adult differ significantly.
The internal organs of children are in closer proximity with each other as compared to adults which results in children being at a higher risk of traumatic injury. Treatment of children using pediatric trauma surgical methods is comparatively more difficult due to the difference in their anatomical, physiological and emotional structure.
A pediatric specialist is a doctor of medicine who has special training and knowledge of the anatomical, physiological and developmental difference between the body of a child and an adult. A pediatric specialist is the one with extensive training and expertise in surgical treatment procedures for infants, children and adults.
Treatment and nursing care for an injured child requires special specialized qualification, precise management and advanced attention to details for a successful pediatric trauma surgery.
Pediatric trauma includes many types of injuries seen commonly in children as a result of an accident or as a result of physical abuse. The most serious kind of pediatric trauma is considered to be a head injury combined with another system injury which makes it more complicated to diagnose and treat. The exact type of surgical procedure to be used to treat a pediatric trauma depends on the specific injury and its location. Mostly, the pediatric specialist will opt to perform treatment surgeries using minimally invasive surgical methods using laparoscopes, arthroscope, endoscope, etc to ensure faster healing and quicker recovery.
There are a vast number of severe and mild traumatic injuries that are treated successfully with pediatric trauma surgery, such as:
The central nervous system is one of the most commonly injured isolated systems in children and is also the leading cause of death in the injured children. A CNS injury may cause retinal hemorrhage, subdural hemorrhage and often display little evidence of external injury.
A severe CNS injury may be treated successfully with the use of fluid resuscitation, careful titration and precise ventilator care.
Many children suffering multiple injuries or CNS trauma have an increased metabolic demand which must be controlled in order to avoid seizures and fever.
Adequate nutritional support after stabilization is the key to meet the elevated metabolism demands and oxygen consumption.
Mild Head Injury
Concussion is considered to be a mild head injury and may or may not, be accompanied by loss of consciousness.
In case the diagnostic tests, such as a computerized tomography (CT) scan, results do not indicate any abnormality the child may be discharged after being under observation in the hospital for around 6 hours and also be advised to be observed at home for certain signs and symptoms of severe head injury such as headaches, behavior disturbance, memory loss and disturbed concentration.
Severe Head Injury
A severe injury is one of the most serious and life-threatening kind of trauma that a child can suffer. Immediate resuscitation goals include preventing secondary brain injury through maximizing cerebral profusion and providing adequate oxygen and at the same time decreasing the growing inter-cranial pressure.
Secondary steps for treatment in case of severe head injury initially include diagnostic imaging tests to determine the extent and exact location of the injury and deciding on the type of pediatric neurological surgical procedure that may be required to treat the symptoms of the severe head injury.
Spinal Cord Injury
A spinal cord injury is not commonly seen in pediatric trauma cases however the pediatric specialist will presume a cervical spine injury until proven otherwise. The most commonly seen spinal injury in children is found to be the first two vertebras. If not detected in time the spinal injuries in children can often give rise to other fractures. Other commonly seen spinal injuries in children are compression fractures, chance fractures of the spine, etc.
Spinal cord injuries need to be detected and diagnosed as early as possible so the pediatric trauma specialist can determine the best method of treatment and thereby prevent the injured spinal cord giving rise to other related complications.
In case a child is seen to suffer from a neck injury the first goal of treatment is to clear the air passage through the airways.
Immediate determination of the type, location and extent of the neck injury is vital to choose the right type of treatment method to prevent further complications from arising.
Ocular (Eye) Injury
Most pediatric eye injuries are seen as a result of playground incidents in children. Any type of eye injury in children should receive immediate medical attention as a child's visual system is under development for up to 9 years of age.
An eye injury in a child is treated usually with a combined effort of an ophthalmologist and a pediatric trauma specialist. Different types of surgical treatment are available for treating the varied eye injuries that occur in children.
Thoracic (Chest) Injury
Thoracic (chest) injuries are considered to be the second most fatal in children after head injuries. Blunt trauma is mostly responsible for inflicting thoracic injuries in children. As a child's rib cage is softer and more pliable than an adult's many thoracic injuries may remain undetected due to the lack of any significant external sign of an injury.
The type and extent of the thoracic injury will determine the kind of surgical treatment required to treat it. Immediate medical attention should be sought after a child is suspected to be suffering from a traumatic injury to the chest.
As children's rib cage is more pliable and softer than an adult even a mild trauma to the abdomen can affect the internal organs such as liver, spleen, kidney, etc adversely. A child's internal organs are more at risk to face injuries due to a trauma to the abdomen.
The pediatric trauma surgeries are highly delicate and should be performed by an expert and well-trained pediatric trauma specialist in order to ensure that the treatment method employed for treating the traumatic injury to the child is most successful.
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