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Waddlle’s triad. Jamie Kuhn BSN, RN.
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What is it?. page14image352244560. Focuses on 3 injury patterns seen in pediatric pedestrian vs motor vehicle 3 phases from impact Injuries: Ipsilateral femoral shaft fractures [4] ipsilateral intra-thoracic and/or intra-abdominal injury Contralateral head injury The combination of these 3 injuries can lead to significant blood loss via internal hemorrhage..
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Why should we care?. According to the World Health Organization unintentional injuries are the leading cause of death in children between 10 to 20 years. In the United States, more than 12,000 children die each year secondary to unintentional injury. [4] Motor vehicle injuries are the leading cause (20% of all deaths). Motor vehicle injuries rank among the top 15 causes of disability in children worldwide..
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Impact one:. Legs verse bumper femur fractures: Physical exam: localized pain, swelling Treatment: Check neurovascular status, open verse closed fracture.
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Impact two. Chest and abdomen verse hood/windshield High suspicion for intra abdominal and intrathoracic injuries Treatment: Fluid resuscitation [3], maintain core temperature, transfer to pediatric trauma center [1].
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Impact three:. Head with road/ground impact Head injuries and spinal injuries Immobilization for spinal injuries Less likely to suffer from neurological injury than adults in the presence of trauma, and incomplete spinal cord injuries (SCI) are more common (75% incomplete versus 25% complete) [2] Head injuries Higher rates of diffuse cerebral edema and parenchymal injuries [5] Treatment: ABC’s keep MAP up for CPP Prevent secondary brain injuries Hyperosmolar Therapy [5].
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references. Amulya K Saxena, M. D. (2021, April 29). Pediatric abdominal trauma treatment & management: Approach considerations, fluid resuscitation, penetrating trauma . Pediatric Abdominal Trauma Treatment & Management: Approach Considerations, Fluid Resuscitation, Penetrating Trauma. Retrieved December 15, 2021, from https:// emedicine.medscape.com /article/1984811-treatment#d9 Copley, P. C., Tilliridou , V., Kirby, A., Jones, J., & Kandasamy, J. (2019, October). Management of cervical spine trauma in children . European journal of trauma and emergency surgery : official publication of the European Trauma Society. Retrieved December 18, 2021, from https:// www.ncbi.nlm.nih.gov / pmc /articles/PMC6791958/ 3.) Gilley M, Beno S. Damage control resuscitation in pediatric trauma. CURR OPIN Pediatr . 2018 June 30 (3):333-343. Paz, M. S., & Mendez, M. D. M. D. (2021, July 22). Waddell Triad . Europe PMC. Retrieved December 15, 2021, from https:// europepmc.org /article/NBK/nbk537094#abstract 5.) Sharp, N., & Tieves , K. (2015, March). Pediatric head trauma . Journal of pediatric intensive care. Retrieved December 18, 2021, from https:// www.ncbi.nlm.nih.gov / pmc /articles/PMC6513126/.