Injury Patterns in Polytraumatized Children and Consequences for the Emergency Room Management Typy poranění u polytraumatizovaných dětí a jejich vliv na urgentní ošetření

INTRODUCTION The effective initial treatment in the emergency room of polytraumatized children requires a sound knowledge of common injury patterns, incidence, mortality, and consequences. The needed initial radiological imaging remains controversial and should be adapted to the expected injury pattern. PATIENTS AND METHODS In this retrospective study, the injury patterns of 56 polytraumatized paediatric patients (age 3 in 80%. Surgical intervention of the head was done in 41%. Thorax injuries were found in 63% with 57% with an AIS > 3 and in 11% a thoracic drainage was needed. Abdominal trauma was found in 34% (surgery 4%) with an AIS > 3 in 32%. Fractures of the spine occurred in 14% (surgery 5%) with an AIS > 3 in 4% and pelvic injuries were diagnosed in 16% (surgery 4%) with an AIS > 3 in 14%. Injuries of the upper extremity were found in 23% (surgery 11%) with an AIS > 3 in 5% and of the lower extremity in 32% (surgery 16%) with an AIS > 3 in 13%. CONCLUSION The authors recommend a whole body CT scan in children who are potentially polytraumatized because of the detected high percentage of head and thorax injuries in polytraumatized children and the needed head surgery. The quickest imaging with a high sensitivity is the whole body CT scan which provides the clinicians with relevant information to initiate life-saving therapy.