Penetrating Paediatric Thoracic Injury

Coley, Emma; Roach, Paul B.; Macmillan, A I; West, A T H; Johnston, Andrew M.

doi:10.1136/jramc-157-03-11

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…A common theme highlighted throughout the literature was the magnitude of paediatric injuries presenting to Field Hospitals on operations, which were predominantly gunshot wounds and explosive injuries, which are simply not seen in peacetime 12. Thus, military personnel face significant challenges in gaining the experience of managing major paediatric trauma in peacetime environments as relevant opportunities within the UK are limited 4.…”

Section: Discussionmentioning

confidence: 99%

“…Having a dedicated consultant present in an ED produces quicker and better decision-making in the care of major trauma patients. As the Iraq and Afghanistan conflicts matured, case studies were published illustrating how invaluable experienced medical or nursing staff are when there is a need to make early decisions in the management of a severely injured paediatric patient 12 13 16. The deployed ED is able to boast 24 h consultant-delivered care.…”

Section: Discussionmentioning

confidence: 99%

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Preparing to care for paediatric trauma patients

Pearce¹

2015

J R Army Med Corps

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Although the exposure to paediatric polytrauma during the conflicts in Afghanistan and Iraq is not replicated in peace time roles, it is likely that wherever emergency nurses are deployed the treatment of children will continue. Analysis of the service evaluation has led to the recommendations for specific skills that emergency nurses could develop during the pre-deployment phase to better prepare for caring for such patients. These include recognition of the sick child/triage, paediatric drug calculations, awareness of the massive transfusion requirements for children and skills to gain intravenous/intraosseous access in a child.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preparing to care for paediatric trauma patients

Pearce¹

2015

J R Army Med Corps

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“…7 Patients with penetrating thoracic injuries require rapid investigation and treatment because they are at risk of rapidly fatal conditions including tension pneumothorax, massive hemothorax, and pericardial tamponade. 28 Most penetrating injuries to the chest (including gunshot wounds) can be managed conservatively with chest drainage, analgesia, and antibiotics. Bullet entry and exit wounds may need to be controlled to prevent persistent air leak.…”

Section: Pulmonary Contusions and Lacerationsmentioning

confidence: 99%

Treatment of Thoracic Trauma in Children: Literature Review, Red Cross War Memorial Children's Hospital Data Analysis, and Guidelines for Management

Manganyi

Brooks

2013

Eur J Pediatr Surg

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“…2 Three-quarters of blunt thoracic traumas are caused by motor vehicle accidents; the remaining are caused by falls and bicycle accidents. 3 In an emergency setting, portable chest radiography is used to detect life-threatening conditions such as tension pneumothorax, large haemothorax, tube malpositioning, and other conditions that require immediate treatment. 4 Nonetheless, computed tomography (CT) is superior to radiography for adult trauma patients in detecting pulmonary contusion, thoracic vascular injuries, and osseous traumas; CT is the gold standard for radiological evaluation of adult patients with thoracic trauma.…”

Section: Introductionmentioning

confidence: 99%

Radiography Versus Computed Tomography in Paediatric Patients after Blunt Thoracic Trauma

Yalçin-Şafak¹,

Akça²

2018

Hong Kong J Radiol

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Objective:To compare radiography with computed tomography (CT) in the detection of blunt thoracic injuries in paediatric patients. Methods: Paediatric patients who underwent radiography and CT after blunt thoracic trauma between February 2015 and January 2016 were retrospectively reviewed. Images were independently evaluated by two experienced radiologists and a consensus reached. The spectrum of blunt thoracic injuries was categorised into the lungs, airways, pleural space, oesophagus, heart, aorta, diaphragm, and chest wall. Considering CT as the gold standard, the sensitivity, specificity, and positive and negative predictive values of radiography were calculated. Results: A total of 39 male and nine female patients aged 1 to 18 years were included; 46 of the 48 patients were clinically stable. CT detected 19 thoracic injuries in 11 patients, whereas radiography detected 15 of the thoracic injuries in eight of the patients. Considering CT as the gold standard, radiography had 73% sensitivity, 100% specificity, and 94% accuracy in detecting thoracic blunt injuries. Conclusion: Most thoracic CT scans in paediatric patients with thoracic blunt trauma were normal. Chest radiography can reliably detect blunt trauma in paediatric patients when evaluated by experienced radiologists. Owing to the risk of radiation exposure, thoracic CT should be performed selectively and based on clinical, laboratory, and chest radiography findings.

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Penetrating Paediatric Thoracic Injury

Abstract: Paediatric penetrating chest trauma is common in conflict, but rarely seen in peacetime. We describe the successful hospital management of a five year old female civilian casualty with life threatening penetrating thoracic trauma caused by a fragment from an explosive device.

Cited by 6 publications

References 5 publications

Preparing to care for paediatric trauma patients

Preparing to care for paediatric trauma patients

Treatment of Thoracic Trauma in Children: Literature Review, Red Cross War Memorial Children's Hospital Data Analysis, and Guidelines for Management

Radiography Versus Computed Tomography in Paediatric Patients after Blunt Thoracic Trauma

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