Download - Injuries In Children
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Injuries in ChildrenInjuries in ChildrenDr. Vivek M. RegeDr. Vivek M. Rege
Pediatric & Neonatal Surgeon
Saifee HospitalSaifee Hospital
Bhatia HospitalBhatia Hospital
Wadia Hospital for ChildrenWadia Hospital for Children
Fortis HospitalFortis Hospital
Dr Vivek Rege Pediatric Surgeon
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Types of InjuriesTypes of Injuries
• External blunt injuriesExternal blunt injuries
• External/Visible cut injuriesExternal/Visible cut injuries
• Internal blunt injuriesInternal blunt injuries
• Penetrating injuriesPenetrating injuries
Dr Vivek Rege Pediatric Surgeon
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Mechanism of injuryMechanism of injury
• Massage in newbornsMassage in newborns
• Fall while walking/running/sports/heightFall while walking/running/sports/height
• Vehicular accident: pedestrian/ in vehicleVehicular accident: pedestrian/ in vehicle
• Crush injury: door, heavy objectCrush injury: door, heavy object
• Sharp object : impalement/ bitesSharp object : impalement/ bites
• Large object falling on child: chest / Large object falling on child: chest / abdomenabdomen
Dr Vivek Rege Pediatric Surgeon
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Site of InjurySite of Injury
• Head injuryHead injury
• Face , neck, mouth injuryFace , neck, mouth injury
• Chest injuryChest injury
• Abdominal injuryAbdominal injury
• Limb injuryLimb injury
Dr Vivek Rege Pediatric Surgeon
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Breast abscess following massageBreast abscess following massage
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Breast abscess following massageBreast abscess following massage
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Abrasions due to dragging along ground by 3 Abrasions due to dragging along ground by 3 dogs who attacked this boydogs who attacked this boy
Dr Vivek Rege Pediatric Surgeon
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Following a dog bite - abrasions & woundFollowing a dog bite - abrasions & wound
Major cutMajor cut
AbrasionsAbrasions
Dr Vivek Rege Pediatric Surgeon
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Deep wound - includes skin & musclesDeep wound - includes skin & muscles
Dr Vivek Rege Pediatric Surgeon
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Dr. Vivek M. Rege
CLWCLW
• Scratched by a PumaScratched by a Puma
• Injury on the noseInjury on the nose
• Active bleedActive bleed
• Deep cutDeep cut
• Requires suturingRequires suturing
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Dr. Vivek M. Rege
After suturingAfter suturing
Excellent healingExcellent healing
Good scarGood scar
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Large cut across tongueLarge cut across tongue
Always to be done under anesthesiaAlways to be done under anesthesiaDr Vivek Rege Pediatric Surgeon
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CLW tongue
Dr Vivek Rege Pediatric Surgeon
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After suturing with self absorbable suturesAfter suturing with self absorbable sutures
CutCutDr Vivek Rege Pediatric Surgeon
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After suturing the under surface of the tongue woundDr Vivek Rege Pediatric Surgeon
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Dr. Vivek M. Rege
Crush injury to the fingerCrush injury to the finger
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Dr. Vivek M. Rege
Crush injury all around fingerCrush injury all around finger
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Finger crushed in door Finger crushed in door
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Finger crushed in door Finger crushed in door
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After cleaning & suturing
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Final result 10 days
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Finger Finger was was
caught caught in the in the
door and door and the skin the skin
was was avulsedavulsed
Dr Vivek Rege Pediatric Surgeon
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Avulsed skin brought along in plastic Avulsed skin brought along in plastic bagbag
Dr Vivek Rege Pediatric Surgeon
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After total healing - excellent resultAfter total healing - excellent result
Dr Vivek Rege Pediatric Surgeon
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Child fell on the handle of cupboard
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Injuries requiring suturesInjuries requiring sutures
• Must be recognised earlyMust be recognised early
• Referred to a surgeon earlyReferred to a surgeon early
• Stop all oral intake immediatelyStop all oral intake immediately
• Send to a hospital directlySend to a hospital directly
• Suturing must be within first 6 hours Suturing must be within first 6 hours ideallyideally
Dr Vivek Rege Pediatric Surgeon
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Head InjuriesHead Injuries
• Ask if child had unconsiousnessAsk if child had unconsiousness
• Ask if child had bleeding ear/nose/ mouthAsk if child had bleeding ear/nose/ mouth
• Ask if child had convulsionAsk if child had convulsion
• Ask if child has vomitedAsk if child has vomited
• Check if child is orientedCheck if child is oriented
• No oral feeds till seen by doctorNo oral feeds till seen by doctor
Dr Vivek Rege Pediatric Surgeon
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Blunt injury – Chest & AbdomenBlunt injury – Chest & Abdomen
• Blunt injury caused by fall, sports, an object falling on Blunt injury caused by fall, sports, an object falling on the bodythe body
• External injury may look small – bruise, scrape or External injury may look small – bruise, scrape or hematomahematoma
• Internal injury may be very major – tear of an organ or Internal injury may be very major – tear of an organ or vesselvessel
• NEVER take chest / abdomen injury casually – go to the NEVER take chest / abdomen injury casually – go to the nearest hospital and shownearest hospital and show
Dr Vivek Rege Pediatric Surgeon
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Blunt Injury ChestBlunt Injury Chest
• Child was playing around a scooterChild was playing around a scooter
• Scooter accidentally fell on her chestScooter accidentally fell on her chest
• She developed swelling from chest She developed swelling from chest upwards to face and down to abdomenupwards to face and down to abdomen
• Difficulty in breathing progressiveDifficulty in breathing progressive
• Time lag: 2 hours after injuryTime lag: 2 hours after injury
Dr Vivek Rege Pediatric Surgeon
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Dr Vivek Rege Pediatric Surgeon
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Dr Vivek Rege Pediatric Surgeon
Swelling up to Swelling up to face , crepitations face , crepitations
all over upper all over upper body due to body due to
leakage of air leakage of air from the lungs from the lungs
outsideoutsideSternal fractureSternal fracture
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Dr Vivek Rege Pediatric Surgeon
Lung Lung collapsed, collapsed,
air air outside outside the lungthe lung
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Tear in Tear in the right the right
main main bronchusbronchus
LungLung LungLung
Dr Vivek Rege Pediatric Surgeon
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Full Full recovery recovery
before going before going home from home from the Hospitalthe Hospital
Dr Vivek Rege Pediatric Surgeon
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Fall from the loft on an open stoveFall from the loft on an open stove
Chest Injury(Penetrating)
Dr Vivek Rege Pediatric Surgeon
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Penetrating injuryPenetrating injury
• Third rod of stove inside the childs’ chestThird rod of stove inside the childs’ chest
• No difficulty in breathingNo difficulty in breathing
• No gross bleedingNo gross bleeding
• No major organ/vessel damageNo major organ/vessel damage
• Child was very luckyChild was very lucky
Dr Vivek Rege Pediatric Surgeon
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Fall from the loft on an open stoveFall from the loft on an open stove
Chest Injury(Penetrating)
Dr Vivek Rege Pediatric Surgeon
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Trachea & Esophagus normal no subcut. emphysema
Penetrating Injury neck midline fall on an Iron rod
Dr Vivek Rege Pediatric Surgeon
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Fall on a sharp compound fenceFall on a sharp compound fence
Entry wound shows muscles cutEntry wound shows muscles cut
Dr Vivek Rege Pediatric Surgeon
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Exit wound in floor of mouth
Tongue
Dr Vivek Rege Pediatric Surgeon
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Glove finger seen inserted from entry wound
Dr Vivek Rege Pediatric Surgeon
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Tract of the iron rod seen
Dr Vivek Rege Pediatric Surgeon
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Muscles sutured in midline
Dr Vivek Rege Pediatric Surgeon
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Dr Vivek Rege Pediatric Surgeon
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Exit wound also closed
Dr Vivek Rege Pediatric Surgeon
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Post operative healing excellentDr Vivek Rege Pediatric Surgeon
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Burns due to Kerosene can falling on the boys head Burns due to Kerosene can falling on the boys head & face due to rats on the loft. Boy was sitting in & face due to rats on the loft. Boy was sitting in
front of a stovefront of a stove
Dr Vivek Rege Pediatric Surgeon
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After local application of Amniotic membraneAfter local application of Amniotic membrane
Dr Vivek Rege Pediatric Surgeon
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Healing of burns on Healing of burns on the face and neck & the face and neck & trunk on the backtrunk on the back
Dr Vivek Rege Pediatric Surgeon
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Dr Vivek Rege Pediatric Surgeon