Archives of disease in childhood. Education and practice edition
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Red blood cell (RBC) transfusions should usually be given only to restore or maintain oxygen delivery to vital organs and tissues. Medical history has clearly documented the importance of blood transfusion in saving lives threatened by acute haemorrhage or severe anaemia. The availability of blood products has facilitated many surgical and medical advances, allowing the support of patients who could not have previously survived invasive therapies. ⋯ Children have different physiology and pathology than adults and many aspects of transfusion practice are poorly researched in the young. This article discusses the most recent evidence available from adult and paediatric research to guide clinical RBC transfusion practice in acute paediatrics. It also discusses the current provision of RBC components for children.
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Trauma accounts for a large proportion of childhood deaths. No data exist about injury patterns within paediatric trauma in the UK. Identification of specific high-risk injury patterns may lead to improved care and outcome. ⋯ Differences in injury patterns and mortality exist between different age groups and high-risk injury patterns can be identified. With increasing age, a decline in the proportion of children with head injury and an increase in the proportion with limb injury were observed. This information is useful for directing ongoing care of severely injured children. Future analyses of the TARN database may help to evaluate the management of high-risk children and to identify the most effective care.