Management of the Multiply Injured Child

Polytrauma describes the condition of a child subjected to multiple traumatic injuries and can be a life-threatening condition. Approximately 30% of children with severe trauma die because of inadequate initial assessment. To reduce the rate of mortality and morbidity, it is essential to know the primary and then the secondary survey of the patient. The first hour (the “golden hour”) after injury is the most critical in influencing the rates of survival from the injuries. Initial resuscitation follows the Advanced Trauma Life Support (ATLS) or Pediatric Advanced Life Support (PALS) protocols (ABCDE), Airway, Breathing, Circulation, Disability (neurologic), Exposure (Extremities). Urine catheter is mandatory too.After the management of the patient in the first survey and stability of the vital signs, the team and the physician can start their second survey. It includes a complete history and a complete and serial examination from head to toe. With Ecchymosis on the abdominal wall, abdominal injury is suspected. Taking radiographs and other imaging according to physical exam are included in the second survey too. Taking a pelvic and chest and bed side lateral neck radiograph is mandatory.