The American College of Surgeon's Advanced Trauma Life Support (ATLS) protocols are based on the trimodal distribution of trauma deaths. The first peak occurs at the accident scene from unsurvivable cardiovascular and CNS injuries. The only treatment for these is injury prevention. The second peak is 1-4 hours after injury. These are due to mass lesions in the CNS (usually subdural or epidural hematomas), solid organ injuries or pleural and pericardial effusions. These deaths can be reduced by effective early management in the ER/PICU. The third peak of trauma deaths occurs in the PICU days to weeks later from complications of injuries, such as sepsis or multi-organ system failure. Many of these complications can also be minimized by the effectiveness of the early management of the patient. EMS and Trauma systems, developed in the early 70s, evolved from experience in the military managing severely injured soldiers in WW2, Korea and Vietnam. The concept of the "Golden Hour" was born, emphasizing the critical importance of rapid, early and effective management of life-threatening injuries, beginning at the accident scene. Because of the child's smaller body mass and less protective musculature and SQ tissue, with organs in close proximity allowing for the transmission of traumatic forces throughout the body, 1/2 of children with severe trauma have multi-system injuries. Therefore, many pediatric surgeons and ER physicians speak of the "platinum half-hour" in pediatric patients. "Introduction" Pages: Previous 1 2 3 4 Next