Editing Paediatric trauma (section)

== Abdominal trauma ==
Fluid resus: two boluses of 20ml/kg crystalloid if necessary, then blood (which is also given as 20ml/kg boluses)

Tachycardia is an important sign, but hypotension is only seen in severe shock


Blunt abdo trauma:

* Overall approach
** Solid organ injury is more common than for adults
** Most injuries to liver, spleen and kidneys can be managed non-operatively regardless of grade (treat haemodynamics rather than grade)
** Operations are rare in blunt trauma
* Indications for CT
** Haemodynamically stable patient with positive FAST
* Indications for laparotomy:
** Peritonitis
** Free intra-abdominal air
** Inability to normalise haemodynamic status despite resuscitation
** Rapidly expanding abdomen with persistent hypotension
** Need for transfusion of more than one-half the blood volume in 24 hours
* Other concerning findings:
** Seat belt sign is concerning in children - 1/9 have a significant intra-abdominal injury, and therefore observation is warranted, even with normal investigations
* Solid organ injury
** The following guidelines ASSUME HAEMODYNAMIC STABILITY
**

*

Penetrating abdo trauma:

* Manage along same lines as adults