Journal of Pediatric Critical Care (Jan 2017)

Imaging of a child with polytrauma

  • Arvind Pandey,
  • Maninder S Dhaliwal,
  • Veena Raghunathan,
  • Tarun Piplani

DOI
Journal volume & issue
Vol. 4, no. 1
pp. 37 – 48

Abstract

Read online

Trauma is the cause of over 45% of deaths in children aged 1 to 14 years. Children are susceptible to polytrauma, as the body of a child has higher elasticity and adverse body size-weight ratio, which allows for a greater distribution of traumatic injuries. The emergency physician or pediatrician manages a polytrauma child by an initial primary survey with an objective to identify and address immediate life-threatening injuries and a secondary survey to provide definitive treatment. Emergency radiology plays a crucial role in the management of a polytrauma child. Several imaging techniques are available, each one with its own advantages and limits and the radiologist should promptly decide which modality to use as to obtain maximum useful information to develop an appropriate treatment and/or surgical plan. The sensitivity of a radiological investigation for polytrauma is more important than its specificity with the primary aim of not missing any critical finding which is life-threatening. X-ray is the first important modality in primary survey, Focused assessment with sonography in trauma (FAST) and extended FAST (e-FAST) have crucial role in hemodynamically unstable patients, whole-body computerized tomography (CT) is a diagnostic aid of the secondary survey and Magnetic resonance imaging ( MRI) plays a pivotal role in patients with diffuse axonal injury and spinal trauma.

Keywords