ABSTRACT
Pediatric multiple trauma victims present a unique set of problems to the emergency physician, pediatrician, or surgeon. Children rarely sustain lethal injury; however, delayed recognition and inappropriate management of the common problems encountered in the pediatric trauma patient can lead to a poor outcome. The ultimate common pathway leading to death in the injured child is profound shock: the inadequate delivery of oxygen to the tissues. It is therefore the goal of the initial phase of resuscitation to rapidly evaluate and treat any immediate life-threatening injuries that compromise tissue oxygenation. This is known in Advanced Trauma Life Support (ATLS) courses as the primary survey or the ABCs of trauma: airway, breathing, and circulation (1). Appropriate management of the ABCs is necessary for optimal outcome in pediatric trauma, regardless of whether it is managed in an adult or pediatric trauma center (2). In fact, with a relatively limited number of pediatric trauma centers, most improvements in pediatric trauma care are likely to come from improvements at combined trauma centers (3).
