Special Populations
Pediatric Trauma
The fellow should be able to:
- Demonstrate an understanding of the unique pediatric physiology
- Demonstrate an understanding of the role of imaging in pediatric trauma and the consequences of ionizing radiation exposure
- Recognize the differences and similarities in the management of solid organ injuries between pediatric and adult patients
- Understand the indications for transfer to a pediatric trauma center
- Understand the possibility of abuse and the role of the physician in reporting suspected cases
Resources
- Topic Summary
- AAST Education Module - Pediatric Trauma for the Adult Surgeon
- Meet the Mentors - Pediatric Trauma Update
- Overview Article:
- Additional Resources:
- Shope C, Alshareef M, Larrew T, Bolling C, Reagan J, Yazdani M, Spampinato M, Eskandari R. Utility of a pediatric fast magnetic resonance imaging protocol as surveillance scanning for traumatic brain injury. J Neurosurg Pediatr. 2021 Feb 5;27(4):475-481. doi: 10.3171/2020.8.PEDS20496. PMID: 33545669.
- Shihan HA, Arora R, Mowbray F, Shukla M, Miranda A, Kannikeswaran N. Minor head injury transfers: Trends and outcomes. Am J Emerg Med. 2021 Jul;45:80-85. doi: 10.1016/j.ajem.2021.02.046. Epub 2021 Feb 24. PMID: 33676080.
- Lucas P. Neff, MD; Jeremy W. Cannon, MD; et al. Clearly defining pediatric massive transfusion: cutting through the fog and friction with combat data. J Trauma Acute Care Surg. 2015..
- Miyata S, Cho J, Lebedevskiy O, Matsushima K, Bae E, Bliss DW. Trauma experts versus pediatric experts: comparison of outcomes in pediatric penetrating injuries. J Surg Res. 2017 Feb;208:173-179. doi: 10.1016/j.jss.2016.09.040. Epub 2016 Sep 28. PMID: 27993205.
- Pediatric Cspine clearance:
- Herman MJ, Brown KO, Sponseller PD, Phillips JH, Petrucelli PM, Parikh DJ, Mody KS, Leonard JC, Moront M, Brockmeyer DL, Anderson RCE, Alder AC, Anderson JT, Bernstein RM, Booth TN, Braga BP, Cahill PJ, Joglar JM, Martus JE, Nesiama JO, Pahys JM, Rathjen KE, Riccio AI, Schulz JF, Stans AA, Shah MI, Warner WC Jr, Yaszay B. Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group. J Bone Joint Surg Am. 2019 Jan 2;101(1):e1. doi: 10.2106/JBJS.18.00217. PMID: 30601421.
- EAST Guidelines
- PECARN
Trauma in Pregnancy
The fellow should be able to:
- Demonstrate an understanding of the unique physiology in pregnant patients
- Demonstrate an understanding of the role of imaging in trauma during pregnancy
- Recognize the role of fetal monitoring and risks to the fetus
- Describe changes to operative approach necessary during surgery in the pregnant patient
- Describe the indication and technique for perimortem c-section
Resources
- Topic Summary
- Meet the Mentors - Trauma in Pregnancy
- Overview Article:
- Petrone P, Marini CP. Trauma in pregnant patients. Current Problems in Surgery. 2015;52(8):330-351
- Petrone P, Jiménez-Morillas P, Axelrad A, Marini CP. Traumatic injuries to the pregnant patient: a critical literature review. Eur J Trauma Emerg Surg. 2019;45(3):383-392.
- Downing J, Sjeklocha L. Trauma in pregnancy. Emergency Medicine Clinics of North America. 2023;41(2):223-245.
- Jain V, Chari R, Maslovitz S, et al. Guidelines for the management of a pregnant trauma patient. Journal of Obstetrics and Gynaecology Canada. 2015;37(6):553-571.
- Petrone P, Marini CP. Trauma in pregnant patients. Current Problems in Surgery. 2015;52(8):330-351
- Petrone P, Jiménez-Morillas P, Axelrad A, Marini CP. Traumatic injuries to the pregnant patient: a critical literature review. Eur J Trauma Emerg Surg. 2019;45(3):383-392.
- Downing J, Sjeklocha L. Trauma in pregnancy. Emergency Medicine Clinics of North America. 2023;41(2):223-245.
- Mattox KL, Goetzl L. Trauma in pregnancy: Critical Care Medicine. 2005;33(Supplement):S385-S389
- Jain V, Chari R, Maslovitz S, et al. Guidelines for the management of a pregnant trauma patient. Journal of Obstetrics and Gynaecology Canada. 2015;37(6):553-571.
- Sakowicz A, Dalton S, McPherson JA, et al. Accuracy and utilization patterns of intraabdominal imaging for major trauma in pregnancy. Am J Obstet Gynecol MFM 2023;5:100915.
- Lucas AN, Tay-Lasso E, Zezoff DC, et al. Significant variation in computed tomography imaging of pregnant trauma patients: a retrospective multicenter study. Emerg Radiol. 2023;31(1):53-61.
Trauma in Older Adults
The fellow should be able to:
- Demonstrate an understanding of the unique physiology of the elderly patient
- Understand the consequences of age on outcome in elderly trauma
- Understand the possibility of abuse and the role of the physician in reporting suspected cases
- Describe the role of palliative care in the management of the elderly trauma patient
Resources
Thermal Injury
The fellow should be able to:
- Demonstrate an understanding of the unique physiology of the burn patient
- Demonstrate an understanding of the initial evaluation and care of the burned patient
- Describe the methods used to assess burn surface area
- Understand the role of fluid resuscitation and how to use burn formulas during initial phases of burn care
- Understand the indications for escharotomy in the burned patient
- Recognize the signs/symptoms and management of inhalational injury
- Describe the indications and options for excision and grafting
- Recognize the indications for transfer to a burn center
Resources
Cold Exposure
The fellow should be able to:
- Demonstrate an understanding of the unique physiology of the hypothermic patient
- Demonstrate an understanding of the initial evaluation of a hypothermic patient
- Describe the methods used to rewarm a hypothermic patient
- Describe the treatment of frostbite and the role of adjuvant therapies to improve outcomes
- Understand the role of delayed amputation in severe frostbite
Resources