ABSTRACT
Pediatric trauma victims present a challenging set of problems to the emergency physician, pediatrician, and surgeon. Performance of the primary survey is divided into three separate stages of airway, breathing, and circulation only for discussion purposes. In practice, it is a dynamic process in which the clinician must be aware that all three steps occur concurrently. The proficient physician managing pediatric or adult trauma must be able to evaluate all three simultaneously, not in sequence, and recognize that problems with the airway influence breathing and circulation, and vice versa. The chapter provides a framework upon which to base the initial management of the "Golden Hour" in pediatric trauma. The clinician evaluating pediatric trauma must be familiar with the wide variability in normal vital signs based on age. A pulse rate and blood pressure that are acceptable in an infant may indicate significant hypovolemia in an adolescent.
