Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Sep 1991
ReviewInitial assessment and stabilization of the critically injured child.
The care that the child receives during the initial resuscitation and stabilization of a life-threatening injury makes a critical difference in long-term outcome. Children who die as a result of a traumatic injury usually do so because of airway compromise, irreparable CNS injury, or bleeding. Hypoxia is the final common event by which these three kill children. ⋯ The potential for a good outcome is maximized by expert nursing care for the critically injured child. Expert nursing care includes rapid and accurate assessment and interventions during both the primary and secondary surveys. Knowledge of the anatomic and physiologic differences between children and adults guides the nurse in holistic care of pediatric trauma victims; the nurse must also understand and address the emotional needs of the patients and their families.
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Even though head injury in children is a major health problem facing our nation today, major advances have occurred in our understanding of the epidemiology, pathophysiology, symptomatology, and outcome of these patients. Basic scientists have also contributed to this body of knowledge by demonstrating some unique characteristics of the immature CNS and how it responds to injury. ⋯ Because most pediatric head injuries are nonoperable, it is believed that aggressive medical management to control ICP and prevent secondary injury is responsible for improved outcome. Public education, coupled with legislative support, should prove to be of further benefit.