Trauma and burns in children

Trauma is the leading cause of death and disability in children, most often resulting from blunt trauma sustained in motor vehicle accidents and falls. An immediate coordinated resuscitation may contribute to improved morbidity and mortality outcomes. A multi-professional approach to the treatment of critically injured children should be adopted; where the primary survey aims to identify and manage immediately life-threatening injuries to airway, breathing and circulation. Following cardiovascular stabilization, the secondary survey serves to structure a detailed examination for other more subtle or less severe injuries. Attention to fluid therapy, analgesia, thermoregulation and glucose homeostasis form important aspects of the secondary survey. Children injured in fires may have suffered from smoke inhalation or sustained burns to the upper airway, with rapid swelling of mucosal tissue, which can make immediate control of the airway very challenging. Both flame burns and scalds can cause significant fluid losses and are associated with a significant risk of mortality. This review discusses the principles of the primary and secondary survey in injured children, fluid resuscitation and outlines the management of children suffering from burns.