Pediatric head injury: a pain for the emergency physician?
The prompt diagnosis and initial management of pediatric traumatic brain injury poses many challenges to the emergency department (ED) physician. In this review, we aim to appraise the literature on specific management issues faced in the ED, specifically: indications for neuroimaging, choice of sed...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2015-03-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-14-055.pdf |
| _version_ | 1797897204917075968 |
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| author | Shu-Ling Chong Khai Pin Lee Jan Hau Lee Gene Yong-Kwang Ong Marcus Eng Hock Ong |
| author_facet | Shu-Ling Chong Khai Pin Lee Jan Hau Lee Gene Yong-Kwang Ong Marcus Eng Hock Ong |
| author_sort | Shu-Ling Chong |
| collection | DOAJ |
| description | The prompt diagnosis and initial management of pediatric traumatic brain injury poses many challenges to the emergency department (ED) physician. In this review, we aim to appraise the literature on specific management issues faced in the ED, specifically: indications for neuroimaging, choice of sedatives, applicability of hyperventilation, utility of hyperosmolar agents, prophylactic anti-epileptics, and effect of hypothermia in traumatic brain injury. A comprehensive literature search of PubMed and Embase was performed in each specific area of focus corresponding to the relevant questions. The majority of the head injured patients presenting to the ED are mild and can be observed. Clinical prediction rules assist the ED physician in deciding if neuroimaging is warranted. In cases of major head injury, prompt airway control and careful use of sedation are necessary to minimize the chance of hypoxia, while avoiding hyperventilation. Hyperosmolar agents should be started in these cases and normothermia maintained. The majority of the evidence is derived from adult studies, and most treatment modalities are still controversial. Recent multicenter trials have highlighted the need to establish common platforms for further collaboration. |
| first_indexed | 2024-04-10T07:54:55Z |
| format | Article |
| id | doaj.art-0f4e462753e04afcae04178aeee1cc34 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:54:55Z |
| publishDate | 2015-03-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-0f4e462753e04afcae04178aeee1cc342023-02-23T05:26:47ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252015-03-01211810.15441/ceem.14.05525Pediatric head injury: a pain for the emergency physician?Shu-Ling Chong0Khai Pin Lee1Jan Hau Lee2Gene Yong-Kwang Ong3Marcus Eng Hock Ong4 Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore Children’s Intensive Care Unit, KK Women’s and Children’s Hospital, Singapore Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore Department of Emergency Medicine, Singapore General Hospital, SingaporeThe prompt diagnosis and initial management of pediatric traumatic brain injury poses many challenges to the emergency department (ED) physician. In this review, we aim to appraise the literature on specific management issues faced in the ED, specifically: indications for neuroimaging, choice of sedatives, applicability of hyperventilation, utility of hyperosmolar agents, prophylactic anti-epileptics, and effect of hypothermia in traumatic brain injury. A comprehensive literature search of PubMed and Embase was performed in each specific area of focus corresponding to the relevant questions. The majority of the head injured patients presenting to the ED are mild and can be observed. Clinical prediction rules assist the ED physician in deciding if neuroimaging is warranted. In cases of major head injury, prompt airway control and careful use of sedation are necessary to minimize the chance of hypoxia, while avoiding hyperventilation. Hyperosmolar agents should be started in these cases and normothermia maintained. The majority of the evidence is derived from adult studies, and most treatment modalities are still controversial. Recent multicenter trials have highlighted the need to establish common platforms for further collaboration.http://www.ceemjournal.org/upload/pdf/ceem-14-055.pdfpediatricschildcraniocerebral traumabrain injuries |
| spellingShingle | Shu-Ling Chong Khai Pin Lee Jan Hau Lee Gene Yong-Kwang Ong Marcus Eng Hock Ong Pediatric head injury: a pain for the emergency physician? Clinical and Experimental Emergency Medicine pediatrics child craniocerebral trauma brain injuries |
| title | Pediatric head injury: a pain for the emergency physician? |
| title_full | Pediatric head injury: a pain for the emergency physician? |
| title_fullStr | Pediatric head injury: a pain for the emergency physician? |
| title_full_unstemmed | Pediatric head injury: a pain for the emergency physician? |
| title_short | Pediatric head injury: a pain for the emergency physician? |
| title_sort | pediatric head injury a pain for the emergency physician |
| topic | pediatrics child craniocerebral trauma brain injuries |
| url | http://www.ceemjournal.org/upload/pdf/ceem-14-055.pdf |
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