الفهرس 
CONTENTS
Initial Stabilization and EvaluationOnly 14 pages are availabe for public view
 |  | from | 121 |  |  |
| | | from | 121 | | |
Abstract
Pediatric head trauma is one of the major causes of disability, death and health related cost to our society. Despite decades of research, there are still very few data to define the best practice for managing head trauma in its early stages. Hypotension, hypoxia, hyper- and hypocapnia, hyper- and hypoglycaemia all remain potentially avoidable insults, which are associated with worse outcome after head trauma. There is no single treatment, which has been, or is likely in the future, to improve dramatically the outcome for patients with head trauma. Adherence to national and international guidelines may be associated with improved outcome. Nowadays outcomes after head trauma have improved significantly. Critical to the prevention of secondary injury is the maintenance of adequate cerebral perfusion, brain tissue oxygenation, and systemic blood pressure. Monitoring of ICP should be performed in select patients, and ICP levels greater than 20 cm H2O should be treated with furosemide, mannitol, or hypertonic saline and possibly EVD placement, if indicated. Sedatives and analgesics may also aid in lowering ICP. Hypothermia is recommended to increase chances of improved outcome in head trauma. Prevention of early posttraumatic seizures should involve the administration of phenytoin or levetiracetam as soon as possible. AED prophylaxis for late posttraumatic seizures is not supported. With respect to infection prophylaxis, although a short course of antibiotics is recommended for the post intubation period, prolonged courses are not recommended. Furthermore, full nutrition should be achieved by post injury day 7, and mechanical DVT prophylaxis should be administered in all patients without contraindications.