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Kids are not just little adults.

Injuries to children require a different approach than injuries to adults, cautioned experts who attended the National Conference on Pediatric Trauma in September. The conference took place at the Indiana University Medical Center in Indianapolis.

Dr. L. R. Scherer, director of the trauma center at IU's Riley Hospital for Children, pointed out that internal bleeding in children stops more quickly than in adults because the child's blood vessels constrict more readily. Thus, surgery is not necessary in most cases of traumatic injury to internal organs such as spleen, kidneys, or liver. He therefore cautioned general surgeons not to routinely perform emergency surgery for the injured pediatric patient as they would for an adult with the same injury. Eighty percent of such childhood injuries heal themselves, said Dr. Scherer.

Dr. Carden Johnson, director of emergency medicine at the Children's Hospital, Birmingham, Alabama, noted that, besides being smaller, the child's anatomy is also different, necessitating the use of specialized equipment to treat childhood injuries. The most common injuries of children are also different from those of adults, he added. Gunshot and knife wounds are common injuries of adults, whereas children are more likely to have generalized injuries from falls or being struck by motor vehicles.

Dr. Johnson stressed the importance of meeting the special emotional needs of young patients. Doctors also need to learn to control their own emotions and thinking that the child they're treating could be one of their own, he said.

For all of these reasons, children are best treated at major trauma centers whenever possible, where health personnel can more easily recognize the special problems of children. Fortunately, the emergency units of many community hospitals are increasingly being staffed by physicians certified by the American Board of Emergency Medicine.
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Title Annotation:caring for children's injuries
Publication:Medical Update
Date:Nov 1, 1992
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