Patterns of trauma in children & errors in initial management

Objectives: To determine the pattern of trauma and errors in initial management in children. Methodology: A descriptive study was conducted from February 2013 to November 2013. It included children admitted to a surgical department following any kind of trauma severe enough requiring inpatient surgical care. Data regarding patient’s age, sex, type of trauma (blunt, penetrating) clinical presentation, pertinent blood tests and radiological investigations advised were recorded. Outcomes in terms of discharge, morbidity and mortality were documented. Results: Out of 90 patients 74 were males and 16 females. Age range was from 1 year to 14 years with a mean age of 7.5 years. 60 blunt, 18 penetrating injuries, 10 blast injury victims, 2 assault victims. Out of total patients mentioned twenty two patients were referred from other hospitals including tertiary care hospitals. Six of the total referred were hemodynamically unstable. 20 patients underwent tube thoracostomy for pneumo and hemothorax. 30 were subjected to surgery while 40 patients were admitted for observation and were managed conservatively. 4 patients expired on conservative management, 2 died during initial postoperative period, 2 died during resuscitation phase,1died lately with secondary hemorrhage. 81 patients were discharged home. One of the blast injury victim became paraplegic secondary to pellet lying in vertebral canal and another lost his vision from one eye and so they were referred to department of ophthalmology and neurology after primary management. Conclusions: Management errors in basics of trauma care continue even in tertiary care setups despite set guidelines and protocols. Following standardized protocols and early identification and interventions outcome of trauma patients can be improved. Keywords: Blunt, Penetrating, ATLS, hemodynamically unstabl