Trauma and burns in children

Trauma is the leading cause of preventable death in children. Most often resulting from accidents involving motor vehicles or falls. A coordinated resuscitation effort in the early phase may contribute to improved morbidity and mortality outcomes. A multi-professional approach to the initial treatment of a critically injured child should be adopted: the primary survey aims to identify and manage immediately life-threatening conditions relating to a patients airway, breathing or circulatory system. Following respiratary and cardiovascular stabilization, the secondary survey serves to structure a detailed examination for less severe or more occult injuries. Attention to fluid therapy, analgesia, thermoregulation and glucose homeostasis forms an important component of the paediatric resuscitation. Children injured in fires may have flame burns to the upper airway or have suffered smoke inhalation, where immediate control of the airway and ventilation may be challenging. Both flame burns and the more common scalds cause significant fluid losses and carry a high risk of mortality from late complications. This review discusses the principles of performing a primary and secondary survey in injured children, options for fluid resuscitation and outlines the management of children suffering from burns.