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Grand Rounds: Pediatric Trauma

03-16-2021

By Rami Edward Karroum, MD , Pediatric Anesthesiologist, Akron Children's Hospital, Akron, OH

Anesthesiology

More about Rami Karroum, MD


Objectives (Educational Content) :

1. Discuss the epidemiology and pathophysiology of pediatric trauma. 2. Describe the triage, emergency assessment and management of pediatric trauma. 3. Examine the massive transfusion protocol.

Target Audience:

Emergency medicine, surgery, and trauma providers.

Identified Gap:

The American College of Surgeons Committee on Trauma requires a structured effort by trauma programs to demonstrate a continuous process for improving care for injured patients and states that an evidence-based rather than an empiric approach presents more meaningful criteria against which trauma care can be measured. A standardized approach to recurring care issues minimizes unnecessary variation, allow better outcome assessment, and makes changes in care easier to implement and more uniform. They further recommend that all members of the trauma team are knowledgeable about current practices in trauma care, that multidisciplinary education should be ongoing in all trauma centers, and that performance improvement programs should be an important part of educational activities.

Estimated Time to Complete the Educational Activity:

1 hour

Expiration Date for CME Credit:

03-15-2022

Method of Physician Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CME credit.

Disclosure:

Dr. Karroum has indicated that he has no relevant financial interest in any pharmaceutical or medical device company and that this activity was developed independent of commercial interest.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.
 

Bibliography:

Coté CJ,Lerman JR .A Practice of Anesthesia for Infants and Children, 5th ed. Elsevier; 2013

Kortbeek JB, Al Turki SA, Ali J, et al. Advanced trauma life support, 8th edition: the evidence for change. J Trauma . 2008;64:1638–1650.

Judy K. Unintentional injuries in pediatrics. Pediatr Rev . 2011;32:431–438. 

 Brown JK, Jing Y, Wang S, et al. Patterns of severe injury in pediatric car crash victims: Crash Injury Research Engineering Network database. J Pediatr Surg . 2006;41:362–367. 

Koepsell TD, Rivara FP, Vavilala MS, et al. Incidence and descriptive epidemiologic features of traumatic brain injury in King County, Washington. Pediatrics . 2011;128:946–954.

Cooper A, DiScala C, Foltin G, et al. Prehospital endotracheal intubation for severe head injury in children: a reappraisal. Semin Pediatr Surg . 2001;10:3–6.

Krug SE, Tuggle DW. Management of pediatric trauma. Pediatrics . 2008;121:849–854. 

Vanderhave KL, Chiravuri S, Caird MS, et al. Cervical spine trauma in children and adults: perioperative considerations. J Am Acad Orthop Surg . 2011;19:319–327.

Mahajan R, Nazir R, Mehta S. An overview of intraosseous access. Anesth Analg . 2010;111:825–826.

Green et al.Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma: Int J Crit Illn Inj Sci. 2012 Sep-Dec; 2(3): 135–142.

Dehmer JJ, Adamson WT. Massive transfusion and blood product use in the pediatric trauma patient. Semin Pediatr Surg. 2010;19:286–91.

Barcelona SL, Thompson AA, Cote CJ. Intraoperative pediatric blood transfusion therapy: A review of common issues. Part I: hematologic and physiologic differences from adults; metabolic and infectious risks. Paediatr Anaesth. 2005;15:716–26.

Macrae et al. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med 2014; 370:107

Finfer S, Chittock DR, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360:1283

Finfer et al. Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: long-term follow-up of a subgroup of patients from the NICE-SUGAR study. Intensive Care Med 2015; 41:1037