Pediatric trauma resuscitation

Abstract

Care of the injured child differs in important ways from that of the injured adult. The pediatric trauma surgeon must account for these differences when crafting a plan of care. Pediatric patients differ from adults in measurable, distinct biomechanical ways: less mineralization of bone means that the skeleton offers less protection to structures in the CNS, thorax, and abdomen; decreased muscle strength per unit volume means not only diminished protection of the cervical spine and abdomen, but decreased Starling effect in the heart; increased surface area relative to body mass means dramatically increased vulnerability to radiative and evaporative loss of heat and fluid; and scaling of energetics means that babies require three times the energy per kilogram of body mass than adults and have far less reserve. © 2011 Springer Science+Business Media, LLC.