J Trauma
-
Cardiac injuries occur infrequently in children. Although the mechanisms of injury are not unique to the pediatric age group, the frequency of the various injuries is quite different. This unusual nature dictates an enhanced awareness for proper management. ⋯ Two of the children with blunt injuries presented as myocardial contusion and one child survived blunt rupture of the right atrium. Only one death occurred in the series--a newborn baby who died from an unrecognized cardiac tamponade secondary to perforation of the right ventricle during catheterization. The diagnosis and special techniques for management of injuries due to catheter perforation and blunt injuries of the heart in infants and children are discussed.
-
Six hundred eighty-five patients with major blunt thoracic injuries from 1968 through 1977 were retrospectively studied. This series was compared to a similar series from 1959 through 1964. Between 1964 and 1968 a vastly improved hospital was built, laboratory support improved, pressure-controlled ventilators replaced by volume-controlled ventilators and the trauma service was reorganized. ⋯ Mortality was unchanged for isolated flail chest injuries, isolated pneumothorax, isolated hemothorax, and for flail chest injuries, and pneumothorax in patients with concomitant major extrathoracic injuries. In both series deaths from isolated thoracic injuries were rare. It is evident that the continued high mortality for blunt thoracic trauma principally relates to concomitant extrathoracic injuries and that recent treatment innovations have not reduced the mortality of flail chest injuries.