Paediatric chest trauma (part 1) — Initial Lethal Injuries

Abstract

Chest trauma is the second greatest cause of mortality from trauma, a leading cause of death in children over the age of one. Prompt diagnosis can be difficult as the underlying thoracic injuries are often disproportionately severe compared to the visible surface injury and symptoms may not appear for several hours. Diagnosis is easily underestimated, delayed or missed. This is a two part article reviewing paediatric chest trauma and its current management. The injuries are usefully classified into six lethal injuries that need excluding in the primary survey and six hidden injuries that must be considered in the secondary survey. The first article reviews paediatric anatomy and biomechanics, and mechanisms of injury with a view to improving the awareness and understanding of the unique response of children to thoracic trauma. This is followed by an in depth review of each of the six lethal injuries. The subsequent article reviews the six hidden injuries as well as the role of chest trauma in non-accidental injury.