Trauma anaesthesia in paediatrics

Abstract

Paediatric trauma is the leading cause of global death and disability in children older than one year,^1,2 accounting for 40% of all childhood deaths.³ In South Africa, injuries in children younger than 15 years are predominantly caused by road traffic accidents and intentional injuries.³ Despite the overwhelming nature of this problem, relatively little attention is given to this major source of sickness and death in children.⁴

Consideration has to be given to multiple issues which may influence the outcome of the patient, including: airway management, particularly in the presence of a cervical spine injury; the possibilities of a full stomach and the need for rapid sequence intubation; haemodynamic status, particularly in the presence of a traumatic brain injury (TBI); and the potential for significant haemorrhage and transfusion. The topic of trauma anaesthesia within the paediatric population is expansive and involves many topics which cannot be covered in this paper (e.g. non-accidental injury [NAI], burns, near-drowning, detailed advanced trauma life support [ATLS] principles and TBI management).