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Abstract
Trauma care is becoming an increasingly important part of modern medical practice as advances in care reduce the mortality from other diseases. Caring for pediatric patients with trauma is a
complex and integrated process that requires knowledge of the special considerations of pediatric trauma patients and understanding of the pathophysiology and special requirements of the pediatric population.
The provision of safe anesthesia for the pediatric patient depends on a clear understanding of the anatomical, physiological and psychological differences between children and adults.
The infants have a proportionately larger head and tongue, narrow nasal passages, cephalad larynx, a long epiglottis, and a short trachea and neck, the subglottic area is the narrowest part of airway in children; these anatomic features make a challenge for anesthesiologist during intubation.
Physiological difference like renal function is markedly diminished in the neonate, complete maturation of renal function occurs by about 1 years of age, and the functional maturity of the
liver is incomplete. Neonates have a limited capacity to maintain normal body temperature. In the setting of traumatic injury, children typically respond to hypovolemia differently to adults.
Several factors influence childhood injuries, including age, sex, behavior and environment; age and sex are the most important factors affecting the patterns of injury. Head injuries, either alone or in association with multiple system injuries, are the most
severe and cause the most deaths.
The survival of children who sustain major or life-threatening trauma depends upon good prehospital care, appropriate triage, resuscitation by an experienced trauma team in an emergency
center and effective emergent surgery. Physicians who are responsible for the care of a pediatric trauma patient, must be familiar with every tenet of modern trauma care (pediatric advanced life support course certification should be required).
The anesthesiologist should be present when the patient arrivesin the emergency room, this will help to reduce the childhood mortality rate from trauma. The orderly progression of history, physical examination, diagnosis, and treatment must often be
abandoned with trauma patients; because resuscitation has priority over the diagnosis. The goal of treatment is to provide
cardiopulmonary cerebral resuscitation for the critically injured patient.