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Ebook Pediatric critical care medicine (Volume 4: Peri-operative care of the critically ill or injured child - 2nd edition): Part 2

Part 2 book "Pediatric critical care medicine (Volume 4: Peri-operative care of the critically ill or injured child)" includes: Trauma, cardiac surgery and critical care, critical care of the solid organ transplant patient. | Part III Trauma Richard A. Falcone Head and Neck Trauma 14 DerekS. Wheeler Derek Andrew Bruce and Charles Schleien Abstract While the overall mortality rates have decreased significantly TBI remains a significant public health problem. In addition while cervical spine and spinal cord injuries are less common in children compared to adults these injuries are an important source of long-term morbidity and pose a significant burden on the health care system. The management of these injuries has continued to evolve over time. Critically injured children with TBI require the close coordination of management between the PICU team the trauma surgeon and the neurosurgeon. Keywords Traumatic brain injury Depressed skull fracture Closed head injury Cervical spine injury SCIWORA Spinal cord injury Epidural hematoma Subdural hematoma Intracranial hypertension Introduction Trauma is the leading cause of pediatric morbidity and mortality in the United States. The mortality rate due to trauma has declined significantly in all age groups since 1979 largely as a result of aggressive injury prevention programs. However accidental injury still accounts for more than one-third of all childhood deaths 1 . Many of these D.S. Wheeler MD MMM Division of Critical Care Medicine Cincinnati Children s Hospital Medical Center University of Cincinnati College of Medicine 3333 Burnet Avenue Cincinnati OH 45229-3039 USA e-mail derek.wheeler@cchmc.org D.A. Bruce MB ChB Center for Neuroscience and Behavioral Medicine Children s National Medical Center 111 Michigan Avenue NW Washington DC 20010 USA e-mail dbruce@childrensnational.org C. Schleien MD MBA Department of Pediatrics Cohen Children s Medical Center Hofstra North Shore-LIJ School of Medicine 269-01 76 Ave Suite 111 New Hyde Park NY 11040 USA e-mail cschleien@nshs.edu deaths are due to traumatic brain injury TBI 2 . Neck and cervical spinal cord injuries although relatively rare in the pediatric population often have catastrophic .