Article Text

MANAGEMENT OF HEAD TRAUMA IN CHILDREN
  1. B Solomon1
  1. 1Pediatric Clinic Sibiu, Sibiu, Smurd Tg Mures, Romania

Abstract

Background Head trauma represents 80% of total injuries in children, 5% resulting in death at the scene of the injuries. Frequently, patients require complex and prolongued therapy in intensive care units. Most of the moderate and severe cases develop neurologic deficit.

Objectives Study of the frequency, mortality and morbidity of TCC in children; study of the physiopathologic mechanisms of the most important lesions; initiating the first measures of resuscitation and basic and advanced life support; study of the primary and secondary examination protocols, laboratory examinations, on the scene and in the hospital.

Materials and Methods Bibliographic and biostatistic study, GCS, PGCS, AVPU, pediatric trauma score, revised trauma score.

Results Head trauma occurs in 200 of 100,000 patients. TCC represents 40% of deaths due to acute injuries. 17 cases of severe head trauma out of 100,000 die before reaching the hospital, 6 cases out of 100,000 of moderate head trauma, 33% mortality in severe cases and 2.5% in moderate cases. Prognosis depends on the injury mechanism, and the lesions (primary/secondary). Primary and secondary examination, recognising the mechanism and the clinical significance are vitally important for establishing a proper therapeutic plan. Therapy includes measures of acknowledging life threatening conditions, elimination or minimalisation of secondary lesions (hypovolemic shock, high intracranial pressure).

Conclusions Due to high frequency, mortality and morbidity of head trauma in children, it is recommended to master the initial resuscitation protocols, primary and secondary examination, emergency procedures and therapeutic measures.

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