Perioperative anesthetic management of the pediatric trauma patient

The object of this article is to provide the anesthesiologist with an approach to the perioperative management of pediatric trauma. The initial focus is on planning and initial stabilization and transport. This is followed by the immediate management of the trauma patient in the emergency department, with a focus on the management of the airway and support of the circulation. There are some differences of opinion about the similarity of cervical spine injury in children and adults, but there is no question that children do suffer cervical spine injuries frequently following head injury. The anesthetic management of the head-injured patient is focused upon the control of intracranial pressure, and the major method for control is hyperventilation to reduce the CO2. Head trauma patients often have injuries to other body systems, which may account for both their ventilatory and their circulatory problems.