Evaluation And Management Of Pediatric Abdominal Trauma

Muñiz, Antonio MD, FACEP, FAAP, FAAEM
Vella, Adam MD
Whiteman, Paula MD, FACEP, FAAP

¹Authors
²Associate Professor of Emergency Medicine and Pediatrics, The University of Texas Medical School; Medical Director of the Pediatric Emergency Medicine Department, Children's Memorial Hermann Hospital, Houston, TX
³Peer Reviewers
⁴Assistant Professor of Emergency Medicine, Pediatric Emergency Medicine Fellowship Director, Mount Sinai School of Medicine, New York, NY
⁵Medical Director, Pediatric Emergency Medicine, Encino-Tarzana Regional Medical Center; Attending Physician, Cedars-Sinai Medical Center, Los Angeles, CA

Date of original release: March 1, 2008

Date of most recent review: February 10, 2008

Termination date: March 1, 2011

Time to complete activity: 4 hours

Medium: Print & online

Method of participation: Print or online answer form and evaluation

Prior to beginning this activity, see “Physician CME Information” on back page.

Pediatric Emergency Medicine Practice 5(3):p 1-31, March 2008.

Afour-year-old female, who was a lap belt restrained, back-seat-passenger involved in a motor vehicle collision, presents with head pain and right thigh pain. The car she was in hit the guardrail with a frontal impact at 70 mph. The child lost consciousness momentarily. Initial vital signs included a blood pressure of 100/62 mmHg, a heart rate of 136/minute, and a respiratory rate of 36/minute. The only abnormalities on examination included a left parietal contusion and deformity to her right femur. A large-bore intravenous catheter was initiated and 20 mL/kg of 0.9% normal saline solution was administered as she was transported to your emergency department. Your abdominal evaluation revealed a seat-belt contusion with a soft and nontender abdomen.

What are the priorities in the initial evaluation and management of this child? How do you evaluate the potential intra-abdominal injuries?