Symposium: intensive careManagement of the multiply injured child

Injury is the commonest cause of death and morbidity in childhood and accounts for most attendances at paediatric emergency departments. However, the incidence of major trauma in UK children remains low. Optimal management of the multiply injured child relies on anticipation and preparation. This should be followed by a consistent and structured response from healthcare professionals. Initial management involves a primary survey with resuscitation using an 'ABC' approach and treatment of life-threatening injuries as they arise. The details of this are outlined in this review which also highlights important child-specific factors. Once stabilised, injured children must be assessed by secondary survey and, if necessary, transferred to an appropriate tertiary unit. Support from regionalised trauma networks and ongoing training for staff is paramount in optimising outcome of the multiply injured child.