Multiply Injured Pediatric Trauma Patients - Trauma CME - Emergency Department | Digest

Management of Multiply Injured Pediatric Trauma Patients in the Emergency Department

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Points and Pearls Excerpt

  • Commonly missed injuries in pediatric trauma patients include fractures, intracranial injuries, intra-abdominal injuries, retained foreign bodies, and peripheral nerve injuries.
  • Algorithmic progression through the ABCDEs (see Figure 1) of the primary survey will help identify and address life-threatening injuries.
  • In children aged < 12 years, maintain suspicion for SCIWORA (spinal cord injuries without radiographic abnormalities) and document a thorough neurologic examination in high-risk patients.

Most Important References

  • ATLS Subcommittee, American College of Surgeons’ Committee on Trauma. Chapter 10: Pediatric Trauma. Advanced Trauma Life Support Student Course Manual. 9th ed: American College of Surgeons; 2013. (Textbook)
  • Calder BW, Vogel AM, Zhang J, et al. Focused assessment with sonography for trauma in children after blunt abdominal trauma: a multi-institutional analysis. J Trauma Acute Care Surg. 2017;83(2):218-224. (Prospective study; 2188 patients) DOI:
  • Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012;59(3):165-175. (Review) DOI:
  • Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170. (Prospective cohort; 42,412 patients) DOI:
  • Kochanek PM, Carney N, Adelson PD, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents--second edition. Pediatr Crit Care Med. 2012;13 Suppl 1:S1-S82. (Guidelines) DOI:
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Publication Information

Andria Tatem, MD; Rupa Kapoor, MD, FAAP

Peer Reviewed By

Michelle Hughes, DO, FAAP; Lara Zibners, MD, MMEd

Publication Date

June 2, 2018

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