| Abstract: | Now that the crisis situation is past and the child appears to be stable, do not be lulled into a sense of security. Repeated examinations will be necessary to uncover significant internal injuries, such as a subcapsular hematoma of the spleen or liver that gives rise to continuous slow bleeding and may not show signs or symptoms until several hours after the time of injury. the first chest film may be within normal limits. A film several hours later may show the characteristic infiltrates of pulmonary contusion. Arterial blood gases may change before demonstrating other physical signs or symptoms of metabolic or respiratory deficiencies. The primary physician who cares for the multiply injured child must be familiar with the special needs of infants and children. They are not little adults. Dosages of medications differ; these children have special needs to meet for growth and development, and special psychologic needs. In dealing with the very young, do not give up too soon, especially with central nervous system injury. Many of these children have the ability to make a "miraculous' recovery, with little or no residual damage. I would like to make a special plea for the early use of hyperalimentation solution in the treatment of the multiple injury as a means of promoting optimum growth, development, and healing of the injured child. |
