The involvement of children and youth in snowmobiling, mountain climbing, winter hiking, and skiing places them at risk for cold injury. Cold injury may produce either local tissue damage, with the injury pattern depending on exposure to damp cold (frostnip,…
Burns are a leading cause of unintentional injury in children, second only to motor vehicle crashes. There has been a decline in the incidence of burn injury requiring medical care that has coincided with a stronger focus on burn treatment…
Drowning is one of the leading causes of childhood morbidity and mortality in the world. Prevention is the most important step to reducing the impact of drowning injury, followed by early initiation of cardiopulmonary resuscitation (CPR) at the scene. Etiology…
High-altitude illness represents a spectrum of clinical entities with neurologic and pulmonary manifestations that overlap in their presentations and share common elements of pathophysiology. Acute mountain sickness (AMS) is the relatively benign and self-limited presentation, whereas high-altitude pulmonary edema (HAPE)…
The term respiratory distress is used to indicate signs and symptoms of abnormal respiratory pattern. A child with nasal flaring, tachypnea, chest wall retractions, stridor, grunting, dyspnea, and wheezing has respiratory distress. Taken together, the magnitude of these findings is…
Shock is an acute process characterized by the body's inability to deliver adequate oxygen to meet the metabolic demands of vital organs and tissues. Insufficient oxygen at the tissue level is unable to support normal aerobic cellular metabolism, resulting in…
Syncope is defined as a sudden transient loss of consciousness with inability to maintain postural tone. The most common cause of syncope in the normal pediatric population is neurocardiogenic syncope (vasovagal syncope, fainting). Vasovagal syncope is classically associated with a…
Brain death is the irreversible cessation of all functions of the entire brain, including the brainstem. It is also known as death by neurologic criteria and is legally accepted as death in the United States. Epidemiology In children, brain death…
Neurocritical Care Principles The brain has high metabolic demands, which are further increased during growth and development. Preservation of nutrient supply to the brain is the mainstay of care for children with evolving brain injuries. Intracranial dynamics describes the physics…
Lacerations and Cuts Lacerations are tears of the skin caused by blunt or shearing forces. A cut (or a stab ), in contrast, is an injury inflicted by a sharp object. Although distinguishing between the two can be important for…