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Abstract

The commonest cause of death in children is trauma, yet few studies have been undertaken to study their needs in the prehospital setting. This article examines the problems associated with seriously traumatized children in the prehospital setting and reviews their management with reference to the specific differences between adults and children. A systematic review of the primary survey is made. Other important aspects of their care including equipment, analgesia, child abuse and accident prevention are also discussed. The need for further research in this field to allow children to enjoy the standard of care afforded adults is emphasized.

Keywords

analgesia child paediatric prehospital trauma

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References

Advanced Life Support Group . 1999. Prehospital paediatric life support. London: BMJ Publishing Group, 4-5, 8-8, 21-24.

Advanced Life Support Group . 2001. Advanced paediatric life support, 3rd edition. London: BMJ Publishing Group, 7-11.

Allison K , Porter K. 2003. Consensus on the prehospital approach to burns patient management. Trauma 5: 97-101.

American Academy of Paediatrics . 2000. Pediatric education for prehospital professionals. Jones and Bartlett, 130-134.

Birkinshaw R , Zahir M , Ryan B. 1998. Visual assessment of blood loss at accidentscene. Prehospital Immediate Care 2: 197-198.

Bumke K , Maconochie I. 2001. Paediatric capillary refill times. Trauma 3: 217-220.

Castner T , Harz C , Schlor J. 2003. Cooling - out of the bag. Today’s Emergency 9: 90-94.

Cooke MW. 1999. How much to do at the accident scene? Br Med J 319: 1150-1150.

de Vries AP , Kassam Adams N , Cnaan A , ShermanSlate E , Gallagher PR , Winston FK . 1999.Lookingbeyondthe physical injury: posttraumatic stress disorder in children and parents after pediatric traffic injury. Pediatrics 104: 1293-1299.

10.

Dykes EH , Spence LJ , Young JG , Bohn DJ , Filler RM , Wesson DE. 1989. Preventable pediatric trauma deaths in a metropolitan region. J Pediatr Surg 24: 107-111.

11.

Esposito TJ , Sanddal ND , Dean JM , Hansen JD , Reynolds SA , Battan K. 1999. Analysis of preventable pediatric trauma deaths and inappropriate trauma care in Montana. J Trauma 47: 243-253.

12.

Evans RJ , Jewkes F , Owen G et al. 1995. Intraosseous infusion - a technique available for the intravascular administration of drugs and fluids in the child with burns. Burns 21: 552-553.

13.

Gausche M , Lewis RJ , Strattons SJ et al. 2000. Effect of out of hospital pediatric endotracheal intubation on survival and neurologic outcome. A controlled clinical trial. JAMA 283: 783-790.

14.

Institute of Medicine . 1995. Report on emergency medical services for children. A call to action. Pediatrics 96: 173-210.

15.

International Liaison Committee on Resuscitation . 2000. Part10: pediatric advanced life support. Resuscitation 46: 343-399.

16.

Jewkes F. 1998. Paediatric advanced life support. Pre-hospital Immediate Care 2: 83-89.

17.

Jewkes F. 2001. Prehospital emergency care for children. Arch Dis Child 84: 103-105.

18.

Kendall JM , Reeves BC , Latter VS. 2001. Nasal Diamorphine Trial Group. Multicentre randomised controlled trial of nasal diamorphine for analgesia in children with clinical fractures. Brit Med J 322: 261-265.

19.

Kokoska ER , Smith GS , Pittman T , Weber TR. 1998. Early hypotension worsens neurological outcome in pediatric patients with moderately severe head trauma. J Pediatric Surgery 33: 333-338.

20.

Kumar VR , Bachman DT , Kishkaddon RT. 1997. Children and adults in cardiopulmonary arrest: are advanced life support guidelines followed in the prehospital setting? Ann Emerg Med 29: 743-747.

21.

LaRocco BG , Wang HE. 2003. Intraosseous infusion. Prehosp Emer Care 7: 280-285.

22.

Markenson D , Foltin G , Tunik M et al. 1999. The Kendrick Extrication Device used for Paediatric Spinal Immobilisation. Prehosp Emer Care 3: 66-69.

23.

National Association of Emergency Medical Technicians in cooperation with the Committee on Trauma of the American College of Surgeons. 1995. PHTLS basic and advanced, 3rd edition. Mosby Lifeline.

24.

Office of National Statistics . England and Wales. 1998. London: Office of National Statistics.

25.

Pediatric Critical Care Society . 2003. Guidelines for the acute medical management of severe traumatic brain injury in infants children and adolescents. Pediatr Crit Care Med 4: S9-S11.

26.

Personal Communication. 2003. With Joint Royal Colleges Ambulance Liaison Committee.

27.

Personal Communication. 2004. With Joint Royal Colleges Ambulance Liaison Committee Guidelines Group.

28.

Resuscitation Council (UK) . 1996. Should relatives witness resuscitation? London Resuscitation Council (UK).

29.

Revell M , Porter K , Greaves I. 2002. Fluid resuscitation in prehospital trauma: a consensus view. Trauma 4: 21-26.

30.

Royal College of Paediatrics and Child Health . 1997. Prevention and control of pain in children. London: BMJ Publishing Group.

31.

Sanchez JI , Paidas CN. 1999. Childhood trauma now and in the new millennium. Surg Clin North Am 79: 1503-1535.

32.

Shah A , Stanhope R , Mathew D. 1992. Hazards of pharmacological tests of growth hormone secretion in childhood. Br Med J 304: 173-174.

33.

Sharples PM , Storey A , Aynsley Green A , Eyre JA. 1990. Avoidable factors contributing to death of children with head injury. Br Med J 300: 87-91.

34.

Simma B , Burger R , Falk M , Sacher P , Fanconi S. 1998. A prospective, randomised and controlled study of fluid management in children with severe head injury: lactated Ringer’s solution versus hypertonic saline. Crit Care Med 26: 1265-1270.

35.

Strozik KS , Pieper CH , Roller J. 1997. Capillary refill times in newborn babies: normal values. Arch Dis Child 76: F193-F196.

36.

Sunderland R. 2002. Child abuse: recognising the injuries. Trauma 4: 11-16.

37.

Tibby SM , Hatherhill M , Murdoch IA. 1999. Capillary refill time and core-peripheral temperature gap as indicators of haemodynamic status in paediatric intensive care patients. Arch Dis Child 80: 163-166.

38.

Trickey D , Black D. 2000. Long term psychiatric effects of trauma on children. Trauma 2: 261-267.

39.

Wade CE , Grady JJ , Kramer GC , Younes RN , Gehlsen K , Holcroft JW. 1997. Individual patient cohort analysis of the efficacy of hypertonic saline/dextran in patients with traumatic brain injury and hypotension. J Trauma Injury Infection Crit Care 42: S61-S65.